As a worker in New York, you have certain rights regarding workplace safety and the compensation you may receive if you are injured on the job. When you are unfamiliar with these rights, Paul Giannetti, Attorney at Law, can explain them to you and help ensure that the money you receive after a work-related injury is what you need to pay your medical bills, cover treatments like physical therapy, and support your family during your recovery.
Settling Your NY Workers’ Comp Claim- What You Need to Know
New York State law does not limit the amount you may receive if you decide to settle your workers’ compensation claim. The maximum settlement amount is whatever your representation and the insurance carrier’s representation agree to set in your individual case. At the very minimum, you want to cover loss of earnings and any ongoing losses like medical treatment.
To understand what you can reasonably expect to receive in relation to your workplace injury, it’s important to know the difference between benefits that come from a workers’ compensation claim and a personal injury lawsuit, as they have significant differences in New York State. Below is an overview of potential settlement options and an explanation of when a lawsuit may be more appropriate.
Workers’ Compensation Benefits
When you are injured at work, you may be eligible for workers’ compensation benefits through your employer’s insurance carrier. These compensation benefits packages primarily cover medical bills, rehabilitative treatments like physical therapy, and lost wages directly related to on-the-job injuries. The New York State Workers Compensation Board administers this program, which pays benefits based on weekly income.
Cash payments for lost wages are determined on a formula that considers your average weekly wage and the amount of disability you’re judged to have. Between that formula and your medical bills, you can just about figure out the amount of workers comp benefits you can expect during the period of time you are unable to work.
The formula used by the New York State Workers’ Compensation Board to calculate weekly settlement payments is as follows:
- Weekly Rate: 2/3 x average weekly wage x % of disability (for example, partial disability or temporary disability)
Degrees of disability are:
- Temporary Total Disability: You are temporarily unable to earn any wages at all.
- Permanent Total Disability: You suffer a total and permanent loss of wage-earning ability due to permanent impairments.
- Temporary Partial Disability: You temporarily lose partial ability to earn wages.
- Permanent Partial Disability: You are partially disabled on a permanent basis.
Another benefit that may be available is a schedule loss of use award. If you endure a permanent disability from your injury — even if it is a partial disability — the schedule loss of use award could provide an additional sum. This loss must affect your upper and lower extremities, hearing, and/or eyesight. (For example, if you experienced loss of hearing due to the injury, you may pursue this award.) Like the other workers’ comp benefits, the schedule loss of use is based on a formula and is not open-ended.
Section 32 Settlement
In some cases, one party in a workers’ compensation claim might seek to end ongoing benefit payments in favor of a lump sum settlement or annuity. This requires a negotiated settlement called a Section 32 Waiver Agreement.
When calculating this lump sum payment, you and your attorney will typically factor in the following:
- Up to 10 years worth of lost wages
- Future medical expenses
- Whether your injury or injuries have left you with a partial permanent disability
As you can imagine, these lump-sum settlement amounts will vary from one worker to the next.
When it comes to Section 32 Waiver Agreements, the key consideration is their finality. If one of these agreements is negotiated, signed, and approved by the New York Workers Compensation Board, the case ends there and cannot be reopened. So if you, as the injured worker, suffer a relapse of your condition or residual injuries manifest themselves, you have no recourse. Your Section 32 Waiver Agreement ends your claim.
A Section 32 agreement does not have a maximum settlement amount. A negotiated settlement will take into account factors similar to your claim – the medical costs required to treat your injury, the lost income, and the degree of ongoing disability. Compensation settlements of hundreds of thousands, or even into the millions, do happen but every case is unique. An experienced workers’ compensation attorney in New York will help you set reasonable expectations and fight for every dollar to which you’re entitled.
Personal Injury Settlement
New York is one of the few states that does not cap awards from personal injury lawsuits. This is the category the public tends to associate with outsized awards to plaintiffs in the millions or even tens of millions of dollars because personal injury cases can include punitive damages — unlike workers’ compensation cases.
However, most workplace injury cases are handled through the workers’ compensation program instead of civil courts. Even if your workers’ comp claim is initially denied, most appeals still take place through the system set up by the state board. There may be situations, however, where a lawsuit is an option. Examples include:
- The injury was deliberate on your employer’s part and did not occur due to negligence or accident.
- Your employer’s workers’ compensation insurance is not sufficient. For example, the medical benefits don’t cover all your treatment costs.
- Your employer circumvented the law and has no workers comp insurance at all.
- The injury you sustained was caused by the negligence of a third party, such as the manufacturer of the equipment you used at work. In this case, you may be looking at a third-party settlement instead.
Lawsuits over workplace injuries are typically more complex, riskier, and time-consuming than working through a workers’ compensation claim.
How Long Does It Take to Settle a New York Workers’ Comp Case?
Workers’ compensation cases in New York can take anywhere from weeks to over a year to resolve. Because everyone’s case is unique, there is no set timeline, but factors that can impact a timely settlement process include:
- The time it takes the insurer to respond to your attorney with approval or counteroffer.
- The length of time it takes for your attorney and the insurance company to reach an agreement on your compensation. Settlement negotiations can transpire quickly, or they can take days.
- How soon the New York Workers’ Compensation Board can review your stipulation agreement or Section 32 settlement agreement.
- Whether or not a hearing is necessary.
Additionally, most workers do not settle until they have reached maximum medical improvement, which is the stage when they are fully healed and there is no reasonable expectation of further improvement. Before this point, it’s difficult to know how serious your injury is, what your medical expenses will amount to, and how much the injury will affect your ability to earn a living, so you may not want to consider a comp settlement before then.
Do All Workers’ Comp Cases End in Settlements?
While the overwhelming majority of New York workers’ comp cases end in a fair settlement, there are exceptions. If you are not satisfied with the comp settlement amount you were offered or your employer’s insurance carrier has denied your claim, your attorney can take your case to trial. This is a rare outcome, with an estimated 5% of workers’ comp cases ending in litigation, but it can happen.
Your New York workers’ comp lawyer will make all reasonable efforts to avoid the time and expense of a legal battle, but if the insurance company is not dealing with your claim in a fair and expedient manner, litigation may be necessary.
Can I Change My Mind After Settlement?
Possibly, but it depends on the settlement type you selected.
If your circumstances change, you can modify a stipulation agreement. In general, if your medical condition worsens and you are eligible for additional benefits, you can ask the Board to modify your stipulation.
In contrast, a Section 32 agreement is more final. The deadline to cancel a Section 32 settlement in writing is ten days after your hearing. After that point, the settlement is final. This means that you cannot reopen your claim or request additional benefits, even if your condition worsens or a previously unknown injury is discovered, so this type of settlement is best considered after receiving appropriate legal advice.
A New York Workers’ Compensation Lawyer Is Here to Help
When you’ve experienced a serious workplace injury and are worried about your future, determining which settlement option to pursue may be difficult if not impossible. Should you go for weekly benefits or a one-time payment? We understand, and we’re here to help you make the right decision for your case.
Paul Giannetti, Attorney at Law, provides free consultations that can give you a reassuring sense of direction and, if he takes your case, he will handle all negotiations on your behalf and fight for the maximum settlement you need for your future. Contact us online or call (518) 243-8011 to schedule your consultation today.