New York State Workers’ Compensation

What is Workers’ Compensation?

Posted by: William Crossett In: Workers Compensation 15 Dec 2015 Comments: 0 Tags: hurt at work, Injured Worker, new york state workers' compensation, syracuse attorney's, Syracuse Injured Worker, syracuse lawyer

The New York State Workers’ Compensation Law is the exclusive remedy of an employee who is injured or made sick while at work in New York State.
“Exclusive remedy” means that, by law, you cannot sue your employer for an injury or illness that arises from your work. There are some very limited exceptions to this rule, such as where your employer has no Workers’ Compensation insurance. However, you can sue a third party whose negligence caused your injury.
Under New York State Workers’ Compensation Law, you are entitled to:
• Lost wage benefits, and
• Medical care.

The New York State Workers’ Compensation Law requires there be a direct connection or nexus between employment and injury or illness.
The law provides for two types of claims:
• Accidents and
• Occupational Diseases.

Accident
Accident claims generally arise from a sudden, unexpected event. Examples include a slip and fall, auto accident, or a fall from a ladder or other heights. Accidents also include injuries that arise from lifting, pushing, or pulling. Sometimes nurses and other health care professionals are injured while helping those they are caring for.

Occupational Disease
Occupational disease cases traditionally refer to injuries or illnesses that result over time. For example, occupational disease cases can include a secretary or clerk who develops carpal tunnel syndrome from typing or a baker who develops asthma from exposure to flour. Exposure to asbestos or other harmful substances and chemicals are included in this type of case.
Often, there is a thin line between what the law designates as an accident and an occupational disease. There are, however, some important differences regarding statute of limitations, burden of proof, and permanency that must be carefully considered.

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.

The Insurance Company is Paying Me “Without Prejudice”, Now What?

Posted by: MCVLawBlog In: Workers Compensation 10 Sep 2015 Comments: 0 Tags: hurt at work, Injured Worker, mcv law, new york state workers' compensation, syracuse attorney's, Syracuse Injured Worker, syracuse workers compensation

Many times, the carrier will issue payments to you without prejudice. This means that the carrier is taking advantage of Section 21-a of the NYS Workers Compensation Law. Section 21-a allows the carrier to pay you without accepting your case. In other words, the carrier is asserting that the mere fact that they are issuing payments to you cannot be deemed an acceptance of liability for your claim. Rather, they are agreeing to issue payments to you while the record continues to develop or while they await further information.

This does not mean you will have to pay back the awards in the event that the carrier later asserts it is not liable. It simply means that the carrier is not accepting liability by making payments. The carrier may make payments without prejudice for up to one year. Unless the Carrier sends a notice of termination within the year, the payments are deemed an admission of liability.

Sometimes, the carrier may also grant certain treatment without prejudice. This usually pertains to treatment for body sites that are not presently established in your case. The insurance carrier is again saying that, while it is agreeing to pay for certain treatment, it is not accepting the liability for those body sites until the record is further developed. Again, you will not be responsible for the treatment in the event that the carrier later disputes liability for the body site.
Bethany Nicoletti

Email: barliss@mcvlaw.com

Phone: 315-471-1664

Bethany Nicoletti is a graduate of Ithaca College where she earned her B.A. in Communication Studies. She graduated cum laude from University at Buffalo Law School in 2013 and was admitted to the New York State Bar in the Fourth Judicial Department in 2014.

Announcing MCV Law’s Workers Compensation Benefits Calculator

Posted by: William Crossett In: Workers Compensation 22 Jul 2015 Comments: 0 Tags: hurt at work, Injured Worker, mcv law, new york state workers' compensation, New York Workers Compensation, syracuse attorney's, Syracuse Injured Worker, syracuse lawyer, syracuse workers compensation, workers' compensation

How much will I get? This question is usually one of the first things a client asks us when discussing a Workers Compensation case. Previously, to answer this, we would have to get the necessary information from the client, then calculate the weekly benefits, and then finally contact them again so they could hear the result. Now, we have made it much easier! The only thing you have to do is follow the instructions on the calculator page and it will give you an estimate of the benefits you will receive!

Try Our Workers Compensation Benefits Calculator!

Quick Answers By MCV Law: Just What Is The Average Weekly Wage?

Posted by: MCVLawBlog In: Quick Answers, Workers Compensation 15 Jul 2015 Comments: 0 Tags: Accident, bill crossett, hurt at work, Injured Worker, mcv law, new york state workers' compensation, New York Workers Compensation, syracuse attorney's, Syracuse Injured Worker, syracuse lawyer, syracuse workers compensation, workers' compensation

The Average Weekly Wage (AWW) is one of the most important issues in your case. The AWW determines how much you will be paid in the event that you are out of work for a work-related injury. The higher the AWW, the higher your rate of pay. At MCV Law, one of the first things we look at is whether the AWW has been calculated correctly.

The Average Weekly Wage is just that – an average. It is calculated by taking your total earnings for the 52 weeks prior to your injury and dividing that by the number of days worked, giving you the average daily wage. The average daily wage is then subjected to a multiplier depending on the number of days worked, as provided for by Section 14 of the New York Workers’ Compensation Law. For example, Section 14 provides that a seasonal worker’s AWW should be calculated by multiplying the average daily wage by 200, whereas the AWW of an employee who works 6 days per week is calculated using a 300 multiple. However, the vast majority of employees work 5 days per week, and, thus a 260 multiple is generally used. There are various other arguments that can be made to increase an AWW. At Meggesto, Crossett & Valerino, LLP (MCV Law), we work to support the argument that is likely to produce the highest AWW.
The law also accommodates injured workers who had a second job at the time of their accident. This is referred to as “concurrent employment.” The assumption is that, if your injury prevents you from earning wages at another job, those wages should also be replaced. The concurrent employment must be “covered employment,” meaning that the concurrent employer must carry Workers’ Compensation insurance. Your total earnings from your concurrent job are added to your earnings at your primary employment. Just like the primary AWW, arguments can be made to maximize the concurrent AWW.

Section 14 of the law also accommodates minors. Under the Workers’ Compensation Law, the age of majority is 25. If you are injured at work before reaching the age of 25, a “Minor’s Wage Expectancy” calculation is assessed to determine what you would have been making at the age of 25. A Minor’s Wage Expectancy determination applies at the time of permanency. The determination is made by analyzing the injured worker’s performance reviews and potential for promotion, as well as looking at what other employees in the same field are earning. For many, this will substantially increase their AWW.

Lastly, the law sets forth maximum and minimum rates depending on the date of accident. Below is a chart demonstrating the maximum rates since 2009. The current minimum rate is $150.000.

Date of Accident	Maximum Rate
July 1, 2009 – June 30, 2010	$600.00
July 1, 2010 – June 30, 2011	$739.83
July 1, 2011 – June 30, 2012	$772.96
July 1, 2012 – June 30, 2013	$792.07
July 1, 2013 – June 30, 2014	$803.21
July 1, 2014 – June 30, 2015	$808.65
July 1, 2015 – June 30, 2016	$844.29

3 Reasons Why You Should Have an Attorney

Potential clients often ask us whether or not they need an attorney. The short answer to this question is no, injured workers are not required to have an attorney. However, there are 3 key reasons why we believe injured workers should have an attorney.

1. Your Rights – Injured workers need someone on their side. The insurance company will have an attorney representing their rights, so it is important to have someone looking out for your rights. The insurance company does not work for you. In fact, their main goal is to save money. A common misconception is that the insurance company must explain what they are doing to you, but this is not true. The insurance company has no obligation to inform you of your rights or even explain the law to you. Additionally, the Judge does not work for you. While the Judge’s role is to administer justice, the Judge has no obligation to fight for your rights. As claimants’ attorneys, we are on your side and it is our role to see that you receive every benefit you are entitled to under the law.

2. The Paperwork – The Workers’ Compensation system has over 50 forms for injured workers to use for various reasons. In addition to the forms designated for you, there are numerous other forms designated for insurance carriers. If this is not enough, injured workers often receive paperwork from the Workers’ Compensation Board pertaining to their case. This creates a lot of mail and can be very overwhelming for an injured worker simply trying to get better. Also, much of the paperwork can be very difficult to understand. At MCV Law, we help our clients understand the paperwork they receive and help them decipher what is important and what is not.

3. Medical Care – Although most injured workers trust their doctors, many of them are confused by what their doctor is saying in their medical reports. As attorneys, we work to help clarify what is in your medical reports and how it will impact your case. For example, if your doctor has you at 75% temporary disability, he or she is saying something about your ability to return to work.

Although you can Google the law, call the Workers’ Compensation Board, read Blogs, etc., this is not the same as working with a team of dedicated attorneys, client advocates, paralegals, and other important staff that are focused exclusively on representing your interests. Every case is unique and our attorneys strategize, plan, and execute based on the particular facts and circumstances of each case – something the other sources cannot do for you.
Bethany Nicoletti

Email: barliss@mcvlaw.com

Phone: 315-471-1664

Quick Answers By MCV Law: Just What Is New York Workers’ Compensation Law?

Posted by: William Crossett In: Quick Answers, Workers Compensation 08 Jul 2015 Comments: 0 Tags: hurt at work, Injured Worker, mcv law, new york state workers' compensation, New York Workers Compensation, syracuse attorney's, Syracuse Injured Worker, syracuse workers compensation, workers comp, workers' compensation

New York’s Workers Compensation Law is an employee’s only remedy for injuries arising “out of or in the course of employment”. This means that if you are injured or hurt while at work or develop a sickness or disease that is caused by your employment, you are entitled to Workers Compensation benefits. In most cases, the Worker’s Compensation law prevents you from suing your employer, with the exception being an intentional act by the employer, such as an assault.

If your injury, sickness, or disease is a result of the negligence of a third party who is not a co-employee, you may have the right to bring an action in addition to your Workers Compensation case. This is commonly referred to as a third party action.

Some examples of third-party actions are:

An action against a property owner who has a statutory duty to provide a safe place to work. This usually occurs on construction sites, particularly regarding falls from elevated heights.
An action against an owner of an automobile or truck that caused a serious injury to an employee driving in the course of employment.
An action against the manufacturer of a machine or device that caused injury due to a defect or lack of warning.

If a recovery is made in the third-party action, the Worker’s Compensation carrier is entitled to be reimbursed for what was paid in the Workers Compensation case.

In New York, Workers’ Compensation benefits include lost wage benefits and medical care that is causally related to the injury, sickness, or disease.

For a more in depth look at workers compensation, click here.

Disclaimer: Quick Answers by MCV Law is provided by the attorneys and Meggesto, Crossett and Valerino, LLP. The content contained in this post, as well as on the website as a whole, is provided for informational purposes only and should not be construed as legal advice on any matter.

Is it Disability, Compensation or Something Else?

Should I file for Disability, NYS Workers Compensation or something else?

Often people call MCV Law requesting help with a “Disability Case. “ They are injured, unable to work and looking for help to pay the day-to-day bills. The first thing the Attorneys and Staff at MCV Law do is listen.

We carefully listen to your story. We’re listening for particular facts and circumstances that will help us determine what remedy or remedies may be available to you. We ask targeted questions, to determine where you may or may not be in the process of making a claim.

Generally we are trying to determine whether or not you have one of the following:

A New York State Disability Case.
A New York Workers’ Compensation Case.
A No Fault Motor Vehicle Accident Case.
A Personal Injury Action.
A Private Short or Long-Term Disability Case.
A Social Security Disability Case.

Sometimes, there is more than one type of case arising from a single event. For instance if you’re involved in a Motor Vehicle Accident, while Working you have both a Workers Compensation claim and a No Fault Motor Vehicle Accident case. If the Accident was caused by a third-party you may also have a Personal Injury Case. If the injury is life changing you may have a Social Security Disability Case as well.

Of course, every type of case has different rules, the most important of which is the Statute of Limitations. That is the time in which the injured person must act to protect their rights. Often, especially in cases dealing with municipalities or other quasi-government entities, the statute limitations is extremely short. Therefore it is important to seek legal advice shortly after your injury or injuries. MCV Law does not charge you for the initial consultation.

At Meggesto, Crossett & Valerino, LLP, we pride ourselves on being able to assist the injured person with regard to all of the cases listed above. Instead of looking only for one type of case, we look at the injured individual as a whole. We work to craft a legal strategy that is most likely to produce the best result for you, in a timely and cost-effective manner.

Be sure to click here for further information on workers compensation, and here for a more in depth look at social security disability.

6 Things to Know about Independent Medical Exams

1. Do I have to attend? Yes, the insurance carrier is entitled to have you examined by their doctor. If you do not attend it will harm your case. Your benefits may be stopped, and your treatment and prescriptions suspended.

2. What is the purpose of the exam? Generally the carrier is seeking another opinion on the nature and extent of your injuries, your need for treatment, and your level of disability.

3. What can you expect at the exam? An IME is not like a visit to your doctor – the IME is not treating you. The exam is likely to be very quick and focused on your degree of disability or the need for treatment or prescriptions. You may be asked to complete a questionnaire prior to the exam. Answer the questions carefully, and be sure you tell the doctor about any prior injuries or new injuries. Do not exaggerate or overstate your injury.

4. What is the IME looking for? The IME doctor will look for any inconsistencies in your behavior. This could include simple observations or may involve video surveillance. The carrier often has an investigator record video of you the day before the exam, the day of the exam, and the day after the exam to try to find inconsistencies. Be frank with the IME and your doctors about your activities of daily living. Also let the IME know of any side effects of your medications.

5. What occurs after the exam? The IME exam generates a report that is sent to all parties generally within 10 days. The report may or may not agree with your doctor and often will vary, especially in assessing your degree of disability. When the carrier receives the report, they will typically request a hearing to change the level of benefits paid. If the dispute cannot be resolved, litigation will start.

6. What is the role of your attorney when you have an IME? Your attorney is aware of your IME. It is best to talk to your attorney before you attend. Your attorney will also work with you to obtain evidence to counter the IME’s conclusions before a hearing.

7 Predictions for New York Workers’ Compensation in 2015

Posted by: William Crossett In: Workers Compensation 02 Jan 2015 Comments: 0 Tags: bill crossett, crossett & valerino, hurt at work, mcv law, mcvlaw, meggesto, new york state workers' compensation, syracuse attorney's, syracuse workers compensation, william crossett, workers' compensation, workers' compensation 2015

The Team at MCV Law and I have put together our predictions for New York Workers’ Compensation in 2015.

In 2015 injured workers /claimants will see:

1. Confusion over lost wage payments – we all miss the Form C-8 that has been eliminated by the Board. Keep track of your payments or at least your stubs.

2. Reliance on electronic forms – which seek standardized answers to complicated issues, especially for degree of disability. If your disability is less that Temporary Total try to obtain specific written restrictions regarding your employability.

3. Chaos over the implementation of the Non Acute Pain Guidelines that became effective in December of 2014. Discuss with your doctor potential limitations on the medications prescribed.

4. More challenges from insurance companies and Special Funds Conservation Committee regarding long term pain medications. Understand your long term medications and discuss with your doctor how they help you work or complete the activities of daily living.

5. Fewer primary care doctors accepting Workers’ Compensation – we think the fee schedule should be changed so as to encourage participation by all medical providers.

6. Challenges from the Business Council to the Schedule Loss of Use (SLU) portion of the law. MCV Law will continue to work with the Injured Workers Bar Association and the Workers Compensation Alliance to protect your rights.

7. Aggressive pursuit on the part of insurance companies to stop lost wage payments by argument a claimant’s failure to remain “Attached to the Labor Market.” Work with and documents your efforts with the “One Stop Centers”, Keep an active Job search using the Boards form C-258 and participate with Acces-Vr.

William Crossett and the Disability team at Meggesto, Crossett & Valerino, LLP.

Email: crossett@mcvlaw.com

Phone: 315-471-1664