NYS Workers Comp

Major Reform - 2007 Changes For NYS Workers Comp

Prior to July 2007, the Maximum Comp Rate that you can collect in New York is $400.00, for TTD - Temporaty Total Disability benefits.

As of July 1, 2007 NYS Workers Comp will have a major reform

Here are some of the major changes in NYS workers comp

COMP RATE
Pursuant to Sect 2 of BILL NUMBER:A6163 REVISED 3/13/07
New Workers Comp Rate increases to $500.00 as of 07-01-2007
THEN the Maximum Comp Rate will increase to $550 from 07-01-2008
THEN the Maximum Comp Rate AGAIN will increase to $600 from 07-01-2009
As of 07-01-2010 the Maximum Comp Rate will THEN be calculated at 2/3 of the State Average Weekly Wage. This would ensure that the RATE that you receive, would increase with the State Average Weekly Wage.

MEDICAL TREATMENT
New amount required before medical services need a pre-approval - increases to $1,000
Sect 28 of BILL NUMBER:A6163 REVISED 3/13/07 states that the new amount for treatment by a specialist for which an employer is automatically liable without prior authorization from the carrier, or an employer - is INCREASED to $1,000.
In addition, the NYS Workers Comp Board, will publish a list of pre-authorized procedures.

Will you benefit?
IMPORTANT READING - -
Here is a list of persons who may potentially benefit

• Injured Worker who earns more than $600.00 per week - entitled to additional amount in WC


• Injured Workers who need authorization for medical diagnostics and testing under $1,000 - process faster since NO pre-approval is needed if the dollar amount for proposed treatment is under $1,000 and the medical provider who is making the recommendation for the procedure is an authorized medical provider.


• For Physical Therapy - No Pre-authorization will be needed, IF the cost of the physical therapy is expected to be less than $500.00


• Injured Workers who need retraining - - NOW there will be a better potential for voc rehab - job retraining.

Just when you thought that Injured Workers won a major battle - - there is a catch. NOT ALL Injured Workers will gain. In fact some Injured Workers will LOSE MAJOR BENEFIT PAYMENTS.

Will You Be A NYS Injured Worker Who Loses?
Here is a list of Injured Workers in New York who may potentially lose

• Injured Workers who earn less than $600 per week - will receive the same amount of compensation as they would have received under the old system.


• If you are an Injured Workers who has been deemed PPD, and you are NOT able to be retrained for other work,


• If you are an Injured Worker, who may have been Classified PPD (Permanent partial Disability) pursuant to NEW YORK provisions. You would NO LONGER be entitled to receive lifetime benefit payments. INSTEAD a disability ranking system will allow you to ONLY receive payments UP TO TEN years of PPD benefit payments. ( They took away lifetime benefit payments )

PPD Maximum Benefit Payment Weeks

The maximum number of weeks that you can receive for PPD - Permanent Partial Disability is set forth in the schedule below.

Your Maximum Benefit Period is calculated from the date that the you would have been "Classified" as being permanently partially disabled.

% PPD Disability Maximum # Weeks You Can Be Paid for PPD

1% - 15% 225 weeks

16% - 30% 250 weeks

31% - 40% 275 weeks

41% - 50% 300 weeks

51% - 60% 350 weeks

61% - 70% 375 weeks

71% - 75% 400 weeks

76% - 80% 425 weeks

81% - 85% 450 weeks

86% - 90% 475 weeks

91% - 95% 500 weeks

96% - 99% 520 weeks

NOTE - If you are 100% - you should be deemed PTD (Permanently & Totally Disabled)

In case you have not figured this out already – the above payment structure is designed to save the INSURANCE COMPANIES billions of dollars, AND TAKE AWAY from benefit payments from NYS Injured Workers.

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Sect 4 of BILL NUMBER:A6163 REVISED 3/13/07
Section 4 of the bill amends section 15(3)(w) of the Workers` Comp Law to create a maximum amount of weeks that you can receive if you have been "Classified as PPD". This provision does NOT change your entitlement to medical services. The maximum benefit payment weeks range from 225 weeks where your loss of wage-earning capacity is 15 percent or less - - up to 525 weeks where your loss of wage-earning capacity is greater than 95 percent.
This section of the bill was SUPPOSEDLY designed to protect Injured Workers after their indemnity payments expire by creating a presumption that medical services will continue. This bill is supposed to place the burden on the workers comp carrier to prove WHY they would discontinue or suspend your medical treatment. If you have been injured and have filed a claim, and are at this point, you already know that the workers comp carriers will do everything they can to stop your medical treatments if they can.

REMEMBER - The MAIN GOAL of the Workers Comp Carriers is to CUT COSTS by reducing your benefits, and to CLOSE YOUR FILE AS QUICKLY AS POSSIBLE.

NEVER let anyone lead you to believe differently.
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Sections 40 and 41 of BILL NUMBER:A6163 REVISED 3/13/07
amend section 25 of the Workers` Comp Law to reduce the time in which the NYS Workers Comp Board must schedule a pre- hearing conference in a controverted case. Up until 07/2007, the NYS Workers Comp Board has 60 days to schedule a hearing, after they have received a Notice of Controversion from the workers comp carrier.
AFTER 07/2007, the NYS Workers Comp Board will have only 45 days to schedule a hearing, AFTER THEY RECEIVE a Notice Of Controversy AND a Medical Report. This MEANS THAT if there is NO medical report, the clock does NOT start ticking, and they can take as long as they want.

This bill also indicates that if the issues in your claim have not been resolved within one year after such issues have been raised before the NYS Workers Comp Board, or when the Notice Of Controversy was filed, the Director of the NYS Workers Comp Board may order that your case be transferred to a special part for expedited hearings.
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BILL NUMBER:A6163 REVISED 3/13/07
BEWARE
Section 72 of the bill amends section 13-j(1) of the Workers` Comp Law to remove the prohibition on insurance carriers directing medical treatment with respect to pharmacy and diagnostic networks. WHAT THIS TRANSLATES TO - workers comp insurance carriers would now will BE ABLE TO DIRECT YOUR MEDICAL CARE. Now, the workers comp insurance companies can tell your treating physician what kind of medical treatment you should receive!

For a more in-depth view of NYS Workers Comp issues, visit

http://www.NYSWorkerComp.GettingWorkersComp.com

For general workers comp issues, visit http://www.GettingWorkersComp.com

I injured myself at work, and cut my hand. Then the medical clinic sent me the bill. How do I get workers comp to pay the bill?

In the vast majority of states, workers comp is responsible to pay bills connected to a work-related injury. Here are some pointers about how to get started -

1. Did you file a formal workers comp claim? If you do not file a claim, you may lose your entitlement to be getting workers comp benefits.


2. At the time you sought medical treatment with the clinic, did you specifically TELL THEM THAT IT WAS A WORKERS COMP INJURY?


3. If you did NOT tell the clinic that your injury is a workers comp injury, then they would have been correct to bill you.


4. HOWEVER - if you DID tell them your injury IS a workers comp injury, then they should NOT have billed you.

The best way to correct the situation ((if you have filed a workers comp claim)) is to:

1. Ask your employer if your claim has been properly filed.


2. Ask your employer WHO their workers comp carrier is.


3. Tell your employer that the clinic had billed you directly and that the clinic should send the medical bill DIRECTLY to the workers comp insurance company.


4. Call the clinic and advise them that they need to bill the workers comp insurance company directly.


5. I would ALSO send the clinic a CERTIFIED letter to document your above conversations, to protect your rights, so you can be getting workers comp benefits.


6. In SOME states, the workers comp law imposes PENALTIES AGAINST medical providers who bill the injured workers.


7. Call the clinic & tell them that they need to send the bill DIRECTLY to the workers comp insurance company.


8. If they do NOT answer your questions, you may consider requesting a Hearing at the Workers Comp Board / Division of Workers Comp. That way, the medical provider would be OFFICIALLY held legally liable, AND the Workers Comp Law Judge can impose any necessary penalties against the medical provider who sent you the bill.

If you need to chat with a lawyer for free in a forum setting try www.Prairielaw.com

For additional workers comp resources this site is growing - www.GettingWorkersComp.com

IF you are a New York injured worker, then also visit www.NYSWorkerComp.gettingworkerscomp.com

Thinking about asking anyone how much they got in their workers comp settlement, so you can get an idea of how much you may be entitled to receive in your settlement?

The amount you may be entitled to receive from your workers' comp settlement depends on the following things:

1. What STATE jurisdiction your claim is in


2. What BODY PART you injured


3. Whether your state jurisdiction has a protracted healing period


4. Whether there is an overpayment of TTD benefits


5. Whether you had prior permanent disability


6. Whether the insurance company knows about the prior disability and if they will try to "apportion" the percentage of the prior disability


7. Whether you have an attorney, and what percentage your attorney will take has his fees.


8. Also depends on your AWW (Average Weekly Wage) Rate


9. The number of weeks of permanency benefits that you are entitled pursuant to your state jurisdiction.


10. So if someone tells you how much they received for their workers comp settlement, and if they injured a different body part, or if they injured multiple body parts, it may not do you any good, because the permanency benefits are calculated differently in many states.

For additional workers comp resources, visit www.GettingWorkersComp.com

My goal is to help you:

• Understand how the New York workers comp system works


• How to get the New York workers comp benefits you deserve


• Get Disability Time Frames data


• Uncover Work Exposures; specific to New York


• Get Work Comp Inside Secrets; for your New York claim


• Organize to fight the insurance company


• Win your New York workers comp case and more!

This site is dedicated exclusively to New York Workers Comp.

If you are an Injured Worker from a different state, please click on this Cool Links page, and you will be RE-Directed to a Page where can find help for workers comp issues in your state.

This site was created, because each state jurisdiction is different, and because New York workers comp is very different and unique from other states.

Injured Workers from Jurisdictions other than New York If you are an Oregon Injured Worker, a worker injured in Pennsylvania, injured in Texas, or if you need to understand New York workers comp / Texas workers comp / Florida workers comp / Illinois workers comp / Georgia workers comp / Michigan workers comp / Colorado workers comp / Indiana workers comp / Virginia workers comp / Arizona workers comp, etc.

If you need to understand work comp for Kansas / Indiana work comp / Illinois work comp/ Oklahoma work comp/ Arizona work comp _ or just need to understand about your workers comp claim? We can still help! Portions of our guides can even help you if you are considering hiring a workers comp lawyer. Please click here for links to other states workers comp.