Important: We updated this article in March 2023 so all information below is current and correct. If you were hurt or got sick on the job in the Empire State, here’s the information you need to get the New York workers’ compensation benefits you’re entitled to.
Am I Eligible for New York Workers’ Compensation Benefits?
The New York State Workers’ Compensation Board (WCB) requires most employers must provide workers’ compensation coverage, except for:
- Federal employees
- Members of the clergy
- Independent contractors
- Sole proprietors
- Employees who work for religious, charitable or educational institutions
Pro Tip: To qualify for New York workers’ compensation benefits, you must prove your injury or illness is work-related. Read more about how to qualify.
How Do I File a New York Workers’ Compensation Claim?
If your workplace injury or illness requires emergency or urgent care, seek medical treatment immediately.
Pro Tip: Tell the doctor your injury or illness is work-related and keep your receipts and bills.
While every case is different, the process usually works like this:
1. Get care immediately, then inform your employer in writing about your workplace injury or illness.
You must provide written notice within 30 days. Failure to do so could affect your ability to get benefits.
2. Submit an Employee Claim C-3 Form to the WCB either online or in person.
If you can’t manage either option, call 1-866-396-8314 and a Board representative will help you.
Pro Tip: Filing online is the fastest option.
3. Make sure your employer’s insurer provides a written statement within 14 days about your legal rights.
If they require you to see a doctor in the insurer’s provider network, then they will provide that physician’s contact info.
4. Wait for a decision.
A claims adjuster will accept or deny your claim within 18 days. They must notify you, your employer and the Board about their decision in writing. If approved, you receive biweekly lost wages and full medical benefits. Your physician must submit medical progress reports to the Board and your employer’s insurer biweekly until you’re released from care.
Pro Tip: Any services that cost over $1,000 require prior authorization by the insurer.
5. Take action if your claim’s denied.
The insurer must explain the denial to the WCB. Then a New York Workers’ Compensation Judge holds a pre-hearing conference or hearing to resolve the dispute. If the judge also denies your claim, you have 30 days to dispute it by submitting an RB-89 Application for Board Review explaining why you want to appeal. If the Board denies your claim, then you have another 30 days to appeal through the Supreme Court’s Appellate Division, Third Department. Since this final step falls outside the system, you may owe legal fees.
Pro Tip: We strongly recommend hiring a New York workers’ compensation lawyer to help you appeal.
For more about the New York workers’ compensation program, read these WCB FAQs.
What Else Should I Know About New York Workers’ Compensation?
The Bureau of Labor Statistics analyzes workers’ comp data on most U.S. states and territories. The total number of recordable cases in the Excelsior State decreased during COVID-19, dropping from 206,700 in 2019 to 183,700 in 2021. Claims reported in the service-providing sector followed a similar path, dropping from 120,200 in 2019 to 108,800 in 2021. The total number of employees missing work, transferring jobs or receiving restrictions fluctuated during the period, from 114,908 in 2019 up to 129,800 in 2020 before dipping down to 119,900 in 2021.
Can I Get Free Legal Assistance With My NY Workers’ Comp Claim?
When you’re dealing with a work-related illness or injury, navigating the New York workers’ compensation system can make the discomfort and frustration even worse. You may want to hire an experienced attorney in order to help you get maximum benefits faster. Your lawyer can negotiate with insurers, gather medical evidence to support your claim, and represent you at hearings.
Pro Tip: Workers’ comp attorneys don’t charge any fees unless you win benefits. You pay a reasonable, one-time fee only if your case is successful. See how a free workers’ comp evaluation works.
Want free expert claim help while you’re at home? Click the button below to sign up for a free phone call during regular weekday business hours:
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Margot Lester is the CEO of The Word Factory, a B2B & B2C content marketing agency that provides services for Fortune 100 brands, healthtech companies and SaaS developers. An award-winning business and brand journalist, she writes for daily and weekly newspapers and business journals, national magazines, in-flight publications and leading websites. Margot is also an in-demand writing coach and organizational communications trainer, helping individuals and teams write more effectively. Twitter: @word_factory LinkedIn: linkedin.com/in/margotlester.