While the New York Workers Compensation Law requires prompt medical treatment, injured workers often find their medical treatment anything but prompt. In the last few years the New York Workers Compensation Board implemented rules and regulations supposedly aimed at improving the process, however these rules have only made the process more difficult.

In the greater Syracuse area, where Meggesto, Crossett & Valerino, LLP concentrates its practice, most family practice doctors have declined to treat injured workers, even if they are long standing patients. The doctors primarily complain of cumbersome reporting requirements, insufficient payment, and the lack of respect given to doctors within the Workers’ Compensation system.

Despite the difficulty in obtaining treatment, injured workers are still required to provide medical evidence of their injury, including the treatment they require, their degree of disability, and their doctors’ recommendations. Traditionally, the Workers’ Compensation Board required medical providers to report injuries on a form know as a C-4. The medical provider was supposed to file this form with the Workers’ Compensation Board within 48 hours of treatment and then follow-up with another C-4 after the next visit. Generally, reports were required to be filed every 30-45 days thereafter.

However, the Workers Compensation Board recently updated the forms they require of doctors to a “family of C-4’s.”  Now, not only are doctors still required to file the initial C-4, but they are now required to file a C-4.2 for each visit until permanency. At permanency, doctors are required to report their findings on a form called the C-4.3. And the forms went from one page to four pages!

In addition to requiring more forms, the Workers’ Compensation Board issued new Medical Treatment Guidelines in 2010, which set forth requirements for doctors to follow when treating injured workers. Of course, the guidelines require doctors to file certain forms before performing particular types of treatment. And, if a certain treatment falls outside the guidelines, the doctor is required to file a Variance in order to obtain authorization for such treatment. 

At Meggesto Crossett and Valerino, LLP we understand the problems injured workers have finding medical treatment, obtaining permission and fighting variance denials. Our staff and attorneys understand the forms and the guidelines, and know what it takes to get a Variance granted. We also recommend that you discuss your medical needs with an attorney and be sure you have a strategy that will allow you to get the medical treatment you need to recover.

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. Read more 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.

In the last few months, the attorneys at Meggesto, Crossett & Valerino, LLP have noticed that more injured workers are arriving at our office with multiple forms that they have received. Some of the forms are sent directly by the New York State Workers’ Compensation Board to the injured worker, while others are sent from employers and insurance companies. Some of the forms have come from the Workers’ Compensation Board web site.

I am sure that most injured workers fill out the forms  hoping that doing so will speed up the process and move their case along. While this may be true, it is important to understand the questions asked on the forms and the impact the answers may have on your case. 

The most important form completed by an injured worker is the Employee Claim form, also know as the C-3. The C-3 is the equivalent of a Complaint in a civil action in New York Supreme Court. This form carries high significance within the Workers’ Compensation system and care must be taken when completing this form. Completing this form hastily often leads to problems later on in a case.

An important point to consider when completing this form is that, when a Judge or attorney review the C-3 form, they assume it was completed by a thoughtful, rational person who understands the questions and the consequences of the answers. They are not reading the form from the mindset of an injured worker who is quickly scribbling answers while in pain and waiting for medical care. They are also not reading the form from the point of view of an angry injured worker answering questions late at night because they are mad that they did not receive their check!

The most common area that an injured worker gets into trouble when completing this form is the question pertaining to any prior injuries. The question on the C-3 form asks whether the injured worker remembers a  prior injury to the same body site. Surprisingly, many people make a crucial mistake answering this question, because, they either do not recall a past injury, they think it was to a slightly different body part, or they are afraid that answering yes will somehow hurt their case.

A forgetful answer, a mistake, and, of course, a false answer can lead to a determination that an injured worker has violated the fraud provisions of Section 114-a of the Workers’ Compensation Law. A violation of this provision is likely to cost you all money benefits, both past and future. At Meggesto, Crossett and Valerino, LLP we recommend that you err on the side of caution and that you speak with an attorney before completing the C-3 form in order to protect your right to Workers’ Compensation benefits.

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. Read more 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.

With enrollment now open, I have been asked why the New York State site https://nystateofhealth.ny.gov/ requests information about Workers’ Compensation claims.

While the ACA is new law, the principle that Workers’ Compensation is the primary payer is not.

What this means is that the compensation carrier has the responsibility for paying medical related to your Workers’ Compensation case.  Thus, no other payer, including your private insurance, is required to pay those costs.

It is my opinion that this principle will continue to control, despite the thought that compensation claims will be treated as “preexisting” conditions.  Now, it is unknown what will happen if the compensation carrier is relieved of liability for medical treatment. I suspect, however, that it will depend on how the compensation case is ultimately resolved.

Presently, when both the Medical and Indemnity (lost wages) portions of a compensation case are settled under Section 32 of the Workers’ Compensation Law, provisions are made to allocate a portion of the overall settlement as money for future medical care.  In cases where the Injured Worker is receiving Medicare, approval of a Medicare Set Aside (MSA) is typically obtained.  The idea is that the Injured Worker uses the MSA to pay for future medical cost. If the MSA sum is exhausted, Medicare then steps in and pays pursuant to Medicare’s rules.  I believe that, as time marches forward, a similar situation will take hold under the ACA.

It is also my opinion that the question relating to Workers’ Compensation coverage under the ACA may relate to more than one issue.  That is, if you already have a source of payment for a particular injury, the carrier under the ACA will not have to pay for that condition, thereby eliminating the premium for such coverage. However, if the Workers’ Compensation case was resolved in some other manner, it is likely the premium will be calculated depending on the resolution. I suspect that there may be other actuarial reasons as well.

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. Read more 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.

I am often asked my thoughts on independent medical exams. I question how any doctor can be considered “independent,” so it is necessary to discern what independent means.

Independence is most often defined as being free from outside control and, in the economic sense, self-supporting. However, assuring that one is free from outside control is always difficult, as independent doctors are asked to render an opinion based on a standard formulated by someone else and paid for by someone else.

In New York, the insurance carrier’s doctor is labeled as an Independent Medical Examiner (IME), but, unfortunately, they are far from independent. Indeed, independent doctors are employed primarily for the purpose of conducting exams at the direction of insurance carriers/employers.  Many of the doctors working as independent medical examiners have a very limited private practice or are semi-retired but perform occasional independent exams.  Others have set up a practice that derives a significant income from doing “Industrial” exams, as well as IME’s. Accordingly, independent doctors certainly bring a bias to the exam to perpetuate a stream of revenue.

In the past, but on rare occasions, the Workers’ Compensation Board (“WCB”) has directed that an “Impartial Specialist” examine the claimant, instead of an independent doctor.

In my experience, the WCB has had difficulty finding a physician to fill the role, especially in Central New York where I practice, as we simply do not have many specialty doctors.

In May of this year, the WCB sought applications for Impartial Specialists, but has not yet announced the results of this search. The semantics of Independent versus Impartial make me chuckle, because the carrier still pays for the exam, and at a higher rate for  an impartial exam than for an independent exam.  Moreover, the impartial doctor is still bound by the standard set by the WCB.

To conclude, I doubt that a truly Independent or Impartial exam exists.  It is my opinion that the system is better served if each party’s doctor were required to defend their position.

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. Read more 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.

The biggest decision you will have to make in your case is whether or not to accept a section 32 settlement, which usually means a one-time lump-sum payment, as opposed to ongoing weekly payments. Typically, a Section 32 agreement will end both the carrier’s obligation to make lost wage payments and end their responsibility for medical coverage; although sometimes the Section 32 agreement is limited to lost wages, leaving the medical portion of your claim open.

When considering accepting a one-time payment, instead of ongoing payments, you must weigh many factors, including how long your lost wage benefits are likely to continue, and the cost of your likely future medical needs, including prescriptions.

In March of 2007, the law was changed by placing limits or caps on how long lost wage benefits are paid.  The duration of the payments is determined by your Loss of Wage Earning Capacity (LWEC), in combination with either (a) your reduced earnings (if you are working) or (b) your level of impairment (if you are not working).  The LWEC determination is either reached by agreement or found by the presiding Judge.

If you are on Social Security Disability Income (SSDI) at the time of settlement, that will carry some weight regarding your degree of impairment. However, collecting SSDI is not equivalent to a finding of a 100% LWEC for purposes of New York Worker’s Compensation.

As federal law prohibits a transfer of your medical care from the Workers Compensation carrier to the federal Medicare system, a monetary provision for your medical needs must be made in the Section 32 settlement if your medical is concluded.  This is referred to as a Medicare Set Aside (MSA).  The MSA is a sum of money that you are required to hold/use for your future medical care and treatment.  The idea is that if you exhaust the MSA monies, Medicare will then pick up the cost of care, subject to its rules.

The entire settlement process can be very complicated because it requires both good faith projections as to your future lost wage benefits and medical care, as well as serious negotiations with the carrier, who may or may not be interested in a section 32 agreement.  Typically, Section 32 settlements involve non-schedulable cases such as Back and Neck injuries. However, Schedulable cases such as Hand(s) and Knee(s) injuries may also be the subject of Section 32 Agreements.

Because of the complicated nature of a Section 32 agreement, your interests are best served by working with a local attorney who has experience with the process, and who can offer advice and strategy that works best with your particular situation and goals.

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. Read more 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.

Commentary by Christopher Stringham, Esq.

On December 1, 2010, the NYS Workers’ Compensation Board instituted Medical Treatment Guidelines for the neck, back, shoulders, and knees.  The intent of the treatment guidelines was to have all parties (doctors, attorneys, insurance carriers, and injured workers, etc.) be on the same page when it came to treatment parameters, and to make the treatment authorization process both streamlined and more efficient.

Initially, as all the interested parties became familiar with the treatment guidelines and all of the required forms, a large number of disputes arose as the guidelines only seemed to address new, acute injuries, along with the necessary immediate treatment rendered to one of the covered body sites.  There was no way to address ongoing and palliative care for injured workers who required pain management, either from ongoing therapies (i.e. chiropractic, physical therapy, acupuncture, etc.) or from the prolonged use of medications.

The practical effect of the guidelines was that injured workers who had been dependent on this palliative care had their medical treatment cut off due to the new requirements that placed the burden of proof on doctors to show that the ongoing treatment was effectively making their patient “better” and not just alleviating pain.  This same set of circumstances arises with newly injured workers who exhaust the care that is prescribed by the guidelines, but who still require some treatment to address ongoing, or even permanent, pain issues.

In order to request the review of a treatment denial, injured workers must ask for review by a Law Judge.  This is done by checking the appropriate box on the form MG-2, the same form that the treating doctor used to make the variance request.   (The form can be found here)

As of today, the Medical Treatment Guidelines that became mandatory in late 2010 are still in effect and are still being utilized to bring an end to ongoing treatment.  However, the Workers’ Compensation Board has recently (March 2013) revised the guidelines so that an ongoing maintenance care program (10 Chiropractic/Physical Therapy treatments per year) will be authorized for those injured workers who have both reached maximum medical improvement and been classified with a permanent disability.  The Board is also working to institute chronic pain guidelines.

The Medical Treatment Guidelines were not a positive addition to the Workers’ Compensation system from the perspective of the injured worker.  They have been used as the basis to deny an untold number of treatment requests from treating physicians and made it much more difficult for injured workers with serious injuries and the desperate need for chronic pain management to get the treatment that they require.  However, I am hopeful that the Board’s review of the last three years and its intent to institute chronic care guidelines will lead to a rebalancing of the way in which treatment is rendered to injured workers in the future.

Christopher Stringham

Email: cstringham@mcvlaw.com

Phone: 315-471-1664

Christopher Stringham graduated from Western New England College School of Law in 2010 and was admitted to the New York State Bar as well as the United States District Court, Northern District of New York in 2011. He is a member of the New York State Bar Association, Onondaga County Bar Association, and the Injured Workers’ Bar Association of New York. He has been a member of Meggesto, Crossett & Valerino, LLP since October 2010.

For Meggesto, Crossett, and Valerino claimants with an existing New York State Worker’s compensation case, Compensation Law provides for the reimbursement of certain Medical and Transportation costs that are directly related to the injury of record.

Reimbursable expenses include mileage for transportation to and from Doctor’s visits, as well as out-of-pocket medical expenses for prescriptions and for durable medical equipment such as crutches and braces.

Below is the link to the mileage reimbursement rates.

http://www.wcb.ny.gov/content/main/SubjectNos/sn150_18_1.jsp

Below is the link to our C-257 form generator, which is the form to be used for submitting Medical and Transportation expenses.

http://mcvlawblog.com/practice-areas/workers-compensation/medical-and-transportation-expense-c-257-form-generator/

This form is very straightforward. Be sure to fill in all the necessary information at the top of the form, including name, WCB case Number, Social Security number, and address.  On the bottom half of the form, as well as on the second page, are spaces for you to fill in your expense information.  If you are going to ask for reimbursement of both mileage and medical expenses, it is best to use separate forms in order to keep the mileage and the medical separated.

When calculating mileage, under “Nature of Expense” put the name and address of the Doctor you are visiting. In the second column goes the date of the visit, and in the third column goes the “round-trip” mileage to the Doctor and back to your place of residence.  A trip to the pharmacy to pick up prescriptions is not a covered expense. Parking and toll expenses are, however, covered, with copies of original receipts. Do not try to “pad” the mileage with extra driving, because the examiner will already have an approximation of the miles involved, and discrepancies will slow or stop the reimbursement process.  Be sure to inquire if your carrier offers any home deliveries on prescriptions – more and more carriers are offering such programs.

When applying for Medical reimbursement, under “Nature of Expense,” put the name of the prescription or the type of medical equipment that you are seeking reimbursement for, the date you made the purchase, and the amount spent out-of-pocket. Please note that the carrier will not reimburse for out-of-pocket copays for medication. The carrier will also not reimburse for any prescription or medical equipment without a copy of the original receipt.

When you have completed the form, forward it to your Compensation insurance carrier for reimbursement. There is no statutory time limit for the reimbursement process, and there is no penalty for late payment of medical and transportation expenses, but allow at least a window of 60-90 days to receive payment. If you have not heard anything in 60 days, contact the offices of Meggesto, Crossett, And Valerino, and we will be glad to contact the carrier on your behalf. It is important for all parties involved that you keep a copy of your submission, in the event that payment is incorrect or delayed.

Tips:

o   Make sure the form is complete.

o   Neatness counts – a sloppy or incomplete form will cause delay.

o   Try to submit no more than 6 months’ worth of expenses at a time. If you try to submit several years at once, payment will be delayed, and there is no guarantee that the insurance carrier will be able to go back and pull all the necessary records.

o   If you receive mileage and not all of it is paid, it is possible that the medical records of your visits are not yet available to the carrier. Those records must be matched with your mileage submission. No payments are made until the matching medical reports are filed.

John M. Bellinger
Paralegal

jbellinger@mcvlaw.com

Mr. Bellinger is part of the Worker’s Compensation team at Meggesto, Crossett and Valerino.  This entry was written by Mr. Bellinger under the direction and approval of Attorney Crossett.

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.

Many injured workers find themselves in the dilemma of being unable to return to their prior work, but without medical evidence to support the proposition that they have a temporary or permanent total disability.  In this instance, the New York State Worker’s Compensation Law requires that the injured worker/claimant demonstrate that they are attached to the workforce.

Failure to demonstrate an attachment to the workforce may result in a temporary or permanent suspension of lost wage benefits.

Sometimes, this argument is made by asserting that the claimant has voluntarily removed themselves from the workforce because the claimant has not taken steps to seek work within their abilities. A finding that the injured worker is entitled to Social Security Disability is not a protection from this defense.

Most times attachment to the labor market is raised when the injured worker has been at a partial level of disability for an extended period of time or there’s been a finding a permanent partial disability. Nevertheless, whenever  the injured worker is at a partial level of disability it is best to take steps to demonstrate attachment to the workforce, before the issue is raised by the carrier or the employer

There are three simple things that can be done to demonstrate attachment to the workforce:

• Demonstrate you are working with ACCES- VR.
• Register with New York State One-Stop centers.
• Conduct independent job search and record the information Board form C-258.

ACCES VR stands for adult career and continuing education services – vocational rehabilitation.  ACCES-VR offers a full range of employment services for persons with disabilities. Generally, the process is commenced by an orientation session and then an application and evaluation. We encourage all participants of ACCES-VR to document their involvement and to obtain written confirmation of what can and cannot be offered by ACCES-VR.  For more information visit http://www.acces.nysed.gov/vr/

New York State Department of Labor operates career centers across the state of New York, often referred to as “one-stop”.  The centers assist both disabled and unemployed citizens in finding appropriate work.  Again, we recommend that all participants document their efforts with the One-Stop Center and to continue involvement until the case has been resolved. For detailed information  click on this link http://www.labor.ny.gov/careerservices/special-services.shtm.

Lastly an injured worker with a temporary or permanent partial disability should maintain an ongoing job search. The search should include both part and full time employment consistent with the claimant’s documented restrictions and/or limitations. We recommend that the efforts be documented on the New York State Worker’s Compensation Board form C-258, to be downloaded at this link  http://www.wcb.ny.gov/content/main/forms/c258.pdf . It is our recommendation that independent job search be done in conjunction with participation in ACCES-VR and the New York State Dept. of Labor’s One-Stop centers.

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. Read more 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

The short answer to this all-important question is: Report Your Injury.

The Worker’s Compensation law has a two part statute of limitations.

• The law requires the injured worker give notice of the injury within 30 days of knowing or within 30 days of when he should have known that the injury was related to work.
• The law provides that the claim must be filed within two years of the date of accident or disability in occupational disease claim.

Notice:

It is important to give notice of the injury or occupational disease to a person in a supervisory capacity. Giving notice to your coworker is unlikely to satisfy the requirements under the statute. Oral notice will work, but written notice is better. Many employers require written notice and actually have a rather harsh policy if notice is delayed.

Many times injured workers do not recognize the true nature or extent of the injury when the event occurs. I cannot tell you how many clients have explained to me that they knew they hurt themselves, but thought it would get better overnight or maybe over the weekend, only to find that the next day they couldn’t get out of bed. Sometimes formal notice is delayed because the supervisor is absent, sometimes because of the injured workers pride, and sometimes notice is delayed because of the worker’s fear of losing their job. All valid reasons in equity, but equity rarely carriers the day in a statutory system. If you’re hurt tell your supervisor immediately.

In cases of occupational disease the notice provision can be very confusing as the law actually provides a different analysis based upon the Date of Disability.  The Date of Disability may or may not be the day that the injured worker learns of the occupational disease. Instead it may be the first day of lost time, which could be days, weeks, or even years after knowing that you have a disease or illness caused by your employment. However, it is best to give notice as soon as you know that you have an occupational disease.

Filing a Claim:

The Workers Compensation Board has many forms. While the law does not require a specific form be filed to commence a claim, it is likely that the Worker’s Compensation Board will not act until either a C-2  or a C-3 is filed.

• The C-2 Form “Employers Notice of Injury” is required to be filed by the Employer. However, this form is not always filed, especially if there is no immediate lost time.
• The Injured Worker may also initiate the claim by filing a C-3 “Employees Notice of Injury”. While the filing of a C-3 within two years of the date of injury will ordinarily satisfy the second prong of the Statute of Limitations, this form should be completed with care. In my opinion this form should be completed with assistance of legal counsel, as it is binding and may be used against you.
• It is also likely that the Board will decline to take action unless there is medical evidence to support the proposition that an injury or illness has occurred.

Once the board has all the information they will “Index” the case.  “Indexing” starts the formal clock running for the employer or insurance carrier to decide whether to accept or to controvert (deny) your Worker’s Compensation case. Sometimes, when the Board believes they do not have all the information they need, they may only “Assemble” the case, meaning that the Board has assigned a workers compensation board number (WCB#) but the clock does not start running against the employer or their insurance company. Generally speaking, if the case is “Indexed” the employer or the insurance carrier must make a decision within 25 days to accept or controvert the case.

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. Read more 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.

Until 1914 there was no Workers Compensation Law in the State of New York.

Instead, an injured worker’s remedy was to bring a lawsuit based on common law principles of negligence. That is, the injured worker had to show that the employer owed a duty to him or her, and that the employer breached that duty, causing damage or injury to the worker. The employer was allowed to argue that the injury was a result of the workers own negligence, the result of a fellow worker’s negligence, and/or that the worker had assumed the risk of injury when assuming the job. Given the vast difference in resources between the injured worker and the employer, the battle was rarely fought, and, when fought, the battle was rarely fair.

The social and economic problems arising from work-related injuries prompted the development of Worker’s Compensation Laws at the beginning of the 1900’s. Unfortunately, New York’s Workers Compensation Law did not come into existence until the tragedy that befell  146 women who died at the Triangle Shirt Waist Company in New York City, in our Nation’s worst factory fire. The fire prompted a change in the New York State Constitution allowing for the creation of the Worker’s Compensation Law in 1914.

In essence, the Worker’s Compensation Law is a grand bargain in which the injured worker gives up the right to sue his employer in exchange for a promise of medical care for the injuries arising from the event or illness, and  wage replacement benefits based upon the workers earnings. The Worker’s Compensation Board was established to administer the process and to decide issues of law and fact between the injured worker and either the self-insured employer, or, more commonly, the employers insurance company.

Since 1914 the law has changed and evolved. Currently, medical treatment is subject to treatment guidelines. Wage replacement benefits are limited by the State’s Average Weekly wage, and the duration of benefits is limited pending the injured workers loss of wage earning capacity.

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. Read more 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.