Category Archives: Benefits

Evaluating the Potential Exposure of a Workers’ Compensation Claim In New York

Workers’ Compensation insurance provides cash benefits and medical care for workers who are injured or become ill as a direct result of their job.  Medical benefits include medical treatment provided, under the Workers’ Compensation Law, to injured workers as a result of injuries arising out of and in the course of employment.  Indemnity benefits is compensation paid to the  claimant for non-medical loss resulting from an injury or illness.

To calculate the possible exposure of the claim, both the indemnity

Tatyana Redko
Tatyana Redko, Esq.

and medical benefits should be considered.  The medical benefits based on the medical treatment provided.  The medical treatment can vary from conservative treatment to invasive surgery.  The cost of the medical care depends on the type of care provided. The amount of indemnity benefits a claimant will be entitled to can be calculated by relying on the medical opinions of the treating physician and the independent medical examiner. Continue reading Evaluating the Potential Exposure of a Workers’ Compensation Claim In New York

The Impact of a Social Security Disability Award on New York Workers’ Compensation Benefits

Joseph Melchionne
Joseph Melchionne, Esq.

Social Security Disability Insurance (SSDI) provides protection for injured people who need to return to work without compromising

their rights to other federal and/or state benefits.  According to the Social Security Administration, someone is “disabled” if they are not able to work as the result of an illness or injury that will last for at least twelve (12) months.

SSDI Requirements.

In order to qualify for SSDI a person:

  • must be younger than 65 years of age,
  • must have worked in a job that is covered by Social Security, and
  • must have suffered from an illness or injury that meets the aforementioned Social Security definition of “disability.”

If all of the aforementioned criteria is met, Social Security will provide monthly cash benefits to individuals who are unable to return to work for at least one (1) year because of their impairment. Continue reading The Impact of a Social Security Disability Award on New York Workers’ Compensation Benefits

New York’s Benefit Rate Increases Today.

New Rate.

For workers’ compensation claims with dates of accident or dates of disablement during the period from July 1, 2016 through June 30, 2017, the maximum weekly benefit rate will be $864.32. This is an increase from the old rate which was set at $844.29.

How is the Maximum rate Calculated?

Since July 1, 2010, the maximum weekly benefit rate for workers’ compensation claimants has been two-thirds of the New York State average weekly wage for the previous calendar year, as determined by the New York State Department of Labor (Workers’ Compensation Law §§ 2(16);15(6)). The Department of LaborLink to External Website reported to the Superintendent of the Department of Financial Services that the New York State average weekly wage for 2015 was $1,296.48. Continue reading New York’s Benefit Rate Increases Today.

Calculating Average Weekly Wage in New York Claims

Why is Average Weekly Wage important?

One of the most fundamental aspects of workers’ compensation are the indemnity benefits paid to the injured workers. The purpose is to compensate the injured employee for the time lost from their work due to their on-the-job injury. These benefits are tax exempt, and as such are calculated at a 33% reduction from the employee’s gross salary amount subject to a maximum and minimum which changes every year. The means by which the compensation rate is established is based on the Average Weekly Wage (AWW). This AWW becomes the basis for all monetary calculations the Workers’ Compensation Board will make throughout the duration of the claim.  As such, it is important that the AWW is properly calculated at the outset of the claim.

The Calculation.

Several factors are considered when making the AWW calculation. Has this injured worker been employed for at least 52 weeks prior to the date of injury? If they have, then their gross salary for that 52 week period will serve as the basis for the AWW calculation. If however, they were employed for less than 52 weeks prior to their injury, then the payroll records of another employee will be directed for submission to the Board. In this instance, the similar worker should be in the same field and preferably in the same position, earning similar wages as the injured worker. The similar worker’s salary and days worked will be adapted and applied in calculating  the injured employee’s AWW. Continue reading Calculating Average Weekly Wage in New York Claims