Can I Receive Workers’ Compensation?

The New York State Workers’ Compensation Law provides for two types of hearing loss:
• Traumatic Hearing Loss, which is the result of a sudden, unexpected event, like an explosion
• Occupational Hearing Loss, which is the result of exposure to loud noise over a period of time

What is Covered?

• Your medical treatment, including hearing aids
• A schedule loss of use award, depending on the percentage of hearing loss

The Statute of Limitations

• For Traumatic Hearing Loss, the statute of limitations is 2 years from the date of the event.
• For Occupational Hearing Loss, the statute of limitations is 2 years and 90 days after the knowledge that the loss of hearing is or was due to the nature of employment.

The Process of a Hearing Loss Claim

1. By law, you have to be out of the harmful exposure for 90 days before your hearing loss can be measured. We recommend that you make arrangements to see an otolaryngologist (ear, nose, and throat doctor) after this 90 day period.
2. See an approved otolaryngologist. The Workers’ Compensation Board has a search tool that can be used to find a nearby otolaryngologist.
3. Be sure to give the otolaryngologist a history and description of employment, as well as the type of noise you were exposed to. Also note any noise exposure that you had prior to this job, or currently have in addition to this job.
4. The otolaryngologist will determine whether or not you have experienced hearing loss an complete a form regarding this. They will also file a C-4NARR or C-4 form.
5. Once you have medical evidence, it is important to file a claim using a C-3 form within 2 years of the injury. The Board will then assemble/index a claim. The C-3 form can be tricky and confusing to fill out
6. The insurance company representing your employer will then either accept or controvert the claim. If they controvert the claim, a hearing will occur to determine which issues need to be adjudicated.
7. If your claim is successful, you are entitled to medical equipment related to your hearing loss. You may also be entitled to a schedule loss of use award.
8. At MCV Law, we have developed a process which ensures claims the best chance of success. Don’t hesitate to schedule an appointment to review your claim.

William Crossett IV
Partner

Email: crossett@mcvlaw.com

Phone: 315-471-1664

William Crossett concentrates his practice in the representation of Injured Workers. Since 1982, he has appeared before the Workers’ Compensation Board and the Courts of New York. As an advocate for the Injured Worker, he has testified before the New York State Senate and has presents Continuing Legal Education programs.

STATE INSURANCE FUND CLAIMANTS – PLEASE IGNORE THIS LETTER

As of September 30th, 2015, a letter has been going out from the New York State Insurance Fund to its Workers’ Compensation Claimants. This unfortunately worded letter has caused a bit of a panic with claimants who are insured through the State Insurance Fund.

It is clear from the very first reading that this letter will cause compensation claimants to believe they need to schedule diagnostic tests such as MRI’s or CT Scans immediately, and schedule them at some out-of-state facility.

This is not the case at all.

This letter is nothing more than a list of the home offices of the carrier’s in-network diagnostic preferred providers. These are the main contact numbers for groups like One-Call Diagnostic, and Med-Focus, which many claimants will be familiar with from scheduling tests. These providers administrate the scheduling for diagnostic testing at local offices where your treating physician will send you for testing. These are preferred providers only and there is no requirement to use them in any capacity.

No insurance carrier can order a claimant to get diagnostic testing. As with any other medical testing, diagnostic tests are requested by your treating physician with your full knowledge and consent.

John M. Bellinger
Paralegal

Email: jbellinger@mcvlaw.com

This entry was written by John Bellinger, who is part of the Worker’s Compensation team at MCV Law.

1. Know your medications (i)
   Always keep a list of your current medications, and know which ones you are trying to fill. Be sure you know which medications you take are related to your compensation claim, and which are not.
2. Know your medications (ii)
   Do not be afraid to ask your doctor what your medications are and what they are being prescribed for. Look them up on the internet. Be aware that doctors will prescribe medications for uses which are not considered as primary. For example, a doctor may prescribe a medication for nerve pain that is normally prescribed for seizure behavior. Medications not prescribed for their primary use can raise a red flag with the insurance carrier.
3. Know the prescribing doctor
   Most often, when you have a medical appointment, you will see a nurse practitioner or physician’s assistant. If you do, try to be sure you know the name of the supervising physician who is signing off on your medical reports.
4. Fill prescription as early as possible
   The more time you give the process, the better off you are.
5. Fill in the morning on a weekday, if possible, and avoid Friday, or days prior to a holiday
   Once again, the more time the better – insurance adjusters often have heavy case loads, start their day early, and they are usually unresponsive after 4 PM. Most calls left with the insurance carrier come with an expected response delay of at least 24 hours. It is best to assume a 48 hour turnaround to resolve any prescription that is not being authorized. Avoiding Friday means lowering the chances of going through a weekend without medication.
6. Use the phone
   Whenever possible, attempt to fill prescriptions by phone. There is no mileage reimbursement for trips to the pharmacy. If you are stuck waiting, it is better to wait at home.
7. Contact your attorney
   If you are represented by an attorney, contact the legal staff with any issues filling medications. Adjusters will not speak with represented claimants. Your attorney and their staff are experienced at handling medication issues, and are the quickest road to resolution of any prescription-related problems.
8. Have your information handy
   When you contact your attorney’s office for help with the prescription you should have the following information:
   a. Date of injury
   b. Body part for which medication is prescribed
   c. Name of medication
   d. New medication or refill?
   e. Prescribing physician/office name and location
   f. Name of the filling pharmacy
   g. Phone number of filling pharmacy

John M. Bellinger
Paralegal

Email: jbellinger@mcvlaw.com

This entry was written by John Bellinger, who is part of the Worker’s Compensation team at MCV Law.

Yes – you can collect both NYS Unemployment Insurance benefits and Workers’ Compensation benefits at the same time. Your eligibility for both benefits will generally occur if you are being paid at a partial disability rate from Workers’ Compensation and are deemed ready, willing, and able to work by the Unemployment office. Alternatively, if your doctor’s opine you to be totally disabled and you are receiving Workers’ Compensation benefits at the total rate, you are likely not eligible for Unemployment benefits.

While you can collect both benefits at the same time, you cannot collect more than your Average Weekly Wage from both benefits. For example, if your Average Weekly Wage is set at $500.00 per week, your unemployment benefits will go down if you are collecting more than this from both Workers’ Compensation and Unemployment. Your Workers’ Compensation is set first and your Unemployment benefits are adjusted accordingly. Therefore, you must report your Workers’ Compensation earnings to the Unemployment office.
William Crossett IV
Partner

Email: crossett@mcvlaw.com

Phone: 315-471-1664

William Crossett concentrates his practice in the representation of Injured Workers. Since 1982, he has appeared before the Workers’ Compensation Board and the Courts of New York. As an advocate for the Injured Worker, he has testified before the New York State Senate and has presents Continuing Legal Education programs.

Yes, I said it – every injured worker needs a vacation; just like their coworkers, bosses, and friends.  Injured workers deserve a break from medical appointments, physical therapy, disputes over medication, and from the worry and stress that comes after an injury or illness.  Injured workers need time away from all of this stress to figure out exactly how they are going to move forward.

Every injured worker that Meggesto, Crossett & Valerino, LLP represents wonders “Will I get better? Will I be able to return to my old job? What happens if I can’t go back to the only work I know how to do?”

Injured workers also wonder “When will I be paid?  Will my check arrive regularly to I can pay my bills?  What happens if I do not receive my check?  Why is the amount of my check increasing or decreasing?”

These are all fair questions and concerns that we, as attorneys, strive to answer for our clients every day.  We often find that injured workers get caught up in the immediate, short-term battles, such as attending medical appointment and comprehending the amount of their benefits, and could really use a break from it all.

When the attorneys and staff at Meggesto, Crossett & Valerino, LLP talk to our clients and try to answer these questions, we stress the importance of being in control of their situation.  We consistently remind our clients that they are the “Masters of their Own Density.”  In doing this, we recommend courses of action and strategies that will maximize benefits in the short run, while keeping in mind that we must protect both injured workers and their families in the long run.

When you change your daily routine by waking up in a different place, and where the only decision you have to make is whether to go swimming or fishing, you give your mind a chance to clear itself.  Perhaps even day dreaming while enjoying the sun, or an afternoon spent outside, would held put your mind at ease.  You might find that, when you least expect it, a thought or answer might pop into to your head that you were too busy or anxious before to realize.

Now, I know it is not easy; you may not have the money to enjoy a vacation nor the freedom to delay medical procedures or treatments.  But, we strongly recommend clearing a week or two in your schedule to just get away, even if only to a public park, to clear your head and relieve the stress every injured worker experiences.

Before summer turns to fall, take my advice and find some time to get away.  Who knows – maybe you will have a flash of inspiration.  Even if you do not, simple acts such as shutting the television off, moving your medical appointments, or simply having a change of scenery, can be an easy but important step on the path to becoming the “Master of your Own Density.”

William W. Crossett, IV
Partner

Email: crossett@mcvlaw.com

Phone: 315-471-1664

Mr. Crossett concentrates his practice in the representation of Injured Workers. Since 1982, he has regularly appeared before the Workers’ Compensation Board and the Courts of New York. As an advocate for the Injured Worker, he has testified before the New York State Senate and has presented many Continuing Legal Education programs. Presently, Mr. Crossett serves as President of the Injured Workers Bar Association of New York and is an active member of Workers Compensation Law Division of the New York State Bar Association. In 2012, he was inducted as a fellow in the College of Workers Compensation Lawyers. Mr. Crossett practices throughout Central New York with an office in Syracuse.

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