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What to Expect from the Workers’ Compensation Insurance Company

How the Workers’ Compensation Evaluates Your Work Injury Claim

Pyrros Serres Attorneys Workers CompensationQueens |NYC| Brooklyn |Bronx Workers’ Compensation Lawyers

In the wake of a work-related injury, you want an experienced and knowledgeable workers’ compensation lawyer to help you pursue all the benefits available to you under the law. At Pyrros & Serres LLP, we will aggressively help you seek payment of all medical expenses, as well as compensation for lost wages and any permanent disabilities.

Under the New York workers’ compensation laws, your employer is required to provide coverage for any work-related injuries you suffer. In most instances, your employer will purchase workers’ compensation insurance to cover that liability. As a practical matter, therefore, we are customarily working with insurance companies to recover the benefits to which you are entitled.

It’s important to understand how insurance companies make a profit. An insurer will charge you a premium, based on their assessment of the amount of risk you pose. The greater the risk, the higher the premium. The money collected from premiums is then used to pay any claims that are filed. The fewer claims the insurer pays, the greater their profit. It’s no surprise, then, that the workers’ compensation insurance company has a vested interest in paying as little as possible to resolve your claim.

So what does that mean for you? It means that the workers’ compensation insurer will typically scrutinize your claim, and may engage in any variety of tactics to delay, diminish or deny your claim:

  • You will likely be required to submit to a medical exam conducted by a doctor chosen by the insurance company. That doctor will typically be looking for any basis to deny your claim.
  • The insurance company may argue that your injuries do not prevent you from working, or that they were not work-related
  • The insurance company may try to cut its losses by offering you a cash settlement that’s worth far less than your actual losses

The takeaway? Don’t ever try to handle your workers’ compensation claim on your own. Your case may seem like a slam dunk, but your employer and the insurance company can make it a nightmare.

What You Can Expect from the Workers’ Compensation Insurance Company

Experienced Queens |NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

At Pyrros & Serres LLP, we handle all matters related to workers’ compensation and Social Security disability claims for people in the Bronx, Brooklyn, Queens and across the greater New York City metropolitan area. Because of our reputation for effective advocacy, many of our new clients come to us as referrals from clients and other lawyers.

To learn more about the full scope of our practice, see our practice area overview page.

Pyrros & Serres LLP

Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

Author:Pyrros & Serres, LLP

Workers’ Compensation in New York—What You Need to Know—Part Two

New York City | Queens | Brooklyn | Bronx Workers’ Compensation Lawyers

In the first blog in this two-part series, we discussed what workers’ compensation, who pays for it and how you qualify to receive benefits. But the more important question, at least for you, is “what should I do when I have been hurt on the job?”

Protecting Your Rights—What to Do When You Suffer a Workplace Injury

The first thing you should always do—no questions asked—get the medical attention you need. If you are unable to move under your own power, don’t try to do so. This will often only make things worse. This is not the time to be brave or to shake it off—for the sake of your health and to protect your legal rights, you need to accept that you’ve been hurt and defer to the medical experts to tell you the extent of your injuries. Read More

Experienced NYC | Brooklyn | Bronx | Queens Workers’ Compensation Attorneys

At Pyrros & Serres LLP, we handle all matters related to workers’ compensation and Social Security disability claims for people in Queens, Brooklyn, the Bronx and across the greater New York City metropolitan area. Because of our reputation for effective advocacy, many of our new clients come to us as referrals from clients and other lawyers.

To learn more about the full scope of our practice, see our practice area overview page.

Pyrros & Serres LLP

Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

Workers’ Compensation in New York—What You Need to Know—Part One

Author: Pyrros & Serres, LLP

You’ve been hurt on the job in the state of New York. You’ve heard from others that you are entitled to workers’ compensation benefits. But what does that mean? How does the workers’ compensation system work? Who pays for it and where does it come from?

What Is Workers’ Compensation?

Workers’ compensation is essentially a form of insurance that almost every employer in New York is required to carry. It’s designed to provide coverage when a worker is injured because of the fault of an employer or a co-worker. The benefits you are eligible for when you file for workers’ compensation are designed to cover two specific types of losses: 1) any medical expenses you incur because of the injury; and 2) a portion of your lost wages because of the injury.

As a general rule, workers’ compensation benefits are only available if you are unable to work and are terminated when you return to your job. However, if you have permanent injuries, but can still return to work, you may be entitled to a cash settlement when your workers’ compensation benefits end.

One of the most important things to understand is that workers’ compensation is basically a “no fault” system. That means that you don’t have to show that your employer or a co-worker was negligent—you only have to show that you were injured while working.

Who Pays for Workers’ Compensation?

The premiums for your workers’ compensation insurance are paid by your employer—they are not deducted from your pay.

Workers’ Compensation in New York—What You Need to Know

 

Experienced NYC | Queens | Bronx | Brooklyn Workers’ Compensation Lawyers

At Pyrros & Serres LLP, we provide comprehensive counsel to people with workers’ compensation and Social Security disability claims in Brooklyn, Queens, the Bronx and across the greater New York City metropolitan area. Because of our reputation for effective advocacy, many of our new clients come to us as referrals from clients and other lawyers.

To learn more about the full scope of our practice, see our practice area overview page.

Pyrros & Serres LLP

Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

FAQs—Helping Medical Professionals Understand Workers’ Compensation Claims

Workers Compensation Attorney-Michael-PyrrosAnswers to Common Questions about Workers’ Compensation

When you are a doctor and have a patient come to you claiming to have been injured on the job, it can be extremely helpful to have a basic understanding of the workers’ compensation laws and process. Here are some frequently asked questions about workers’ compensation that have medical implications.

Q: What are the requirements to qualify for workers’ compensation?

A: In the state of New York, there are only two requirements—you must have been working and you must have suffered an injury while on the job. Workers’ compensation is generally considered to be “no-fault,” meaning that the negligence of the worker doesn’t mean a claim will be denied. There are limited circumstances where a claim may be denied—where the injury was suffered while off duty, was self-inflicted, happened while the employee was violating company policy or while the employee was committing an illegal act.

Q: Must the injury occur on company property?

A: No. Any injury sustained while you were performing the duties of your job will be covered, regardless of where it happened. If your job requires that you travel, you can seek benefits for motor vehicle accident injuries or even for a slip and fall at a customer facility. As a general rule, if you leave company property on a personal errand, you are not covered. However, if your boss asks you to do a work-related task (pick up lunch for the office, etc.) while running a personal errand, you may have coverage.

Q: Does workers’ compensation cover only work-related accidents?

A: No. Any injury or illness that arises out of work conditions may be covered. Accordingly, a person who is exposed to toxic substances on the job may be entitled to workers’ compensation benefits for any negative health consequences that result. In addition, employees who experience mental health issues, such as depression or anxiety, may recover workers’ compensation benefits if it can be shown that the mental health problems were work-related.

Q: What medical expenses are covered by workers’ compensation?

A: Workers’ compensation pays for any “reasonable and necessary” medical expenses resulting from a work-related injury. This can include examinations, checkups, urgent care treatment, hospitalization, surgical treatment, anesthesia and medications.

Results-Oriented Workers’ Compensation Lawyers in Queens, New York

At Pyrros & Serres, we bring more than 50 years of combined workers’ compensation experience to injured workers in Queens and across the greater New York City area. We built our practice on personal service and attention, taking the time to learn the details of your case, so that we can take the necessary measures to get the outcome you want. Many of our new cases come to us as referrals from doctors, lawyers and satisfied clients.

We take all types of work-related injury claims, including cases involving:

Occupational Disease or Illness | Traumatic Brain Injury (TBI) | Fractures | Hip, Leg, Foot and Toe Injury| Burns | Paralysis | Spinal Cord Injury | Permanent Scarring or Disfigurement | Amputation or Loss of Limb | Hearing or Vision Loss | Back and Neck Injury | Shoulder, Arm, Hand and Finger Injury | Accidental or Wrongful Death

To learn more about the services we provide, see our practice area overview page.

Author:Pyrros & Serres LLP

Workers’ Compensation Attorneys—Queens, New York

Pyrros-Serres-LLP

Queens Workers’ Compensation Lawyers,What are the Medical Benefits under Workers’ Compensation in New York?

Pyrros-Serres-LLP

New York City |Bronx| Brooklyn | Queens Workers’ Compensation Lawyers

Author: Pyrros & Serres LLP

Under the New York workers’ compensation laws, when you have suffered a workplace injury or have contracted a disease related to your employment, you have the right to file a workers’ compensation claim and to get payment for certain medical expenses. What types of medical bills are covered?

General Medical Care

You are entitled to payment or coverage of all expenses related to any necessary medical care directly related to or arising as a consequence of your work-related injury or illness. Workers’ compensation benefits also cover the costs of recovery, including physical therapy and rehabilitation.

As a general rule, any medical professional providing care to you must be preauthorized by the Workers’ Compensation Board, unless the treatment is an emergency. You have a right to payment of or reimbursement for such medical expenses, even if your injury has not resulted in any time lost at work and you have received no cash benefits for lost wages. If you have requested an authorization, but it has been withheld for more than 30 days, with no stated reason, the treating physician may provide care, if necessary to promote or protect you health or welfare.

Tests and Procedures

If you require any x-rays, MRIs or other tests, or need a surgical procedure, physical therapy or special consultation, you must obtain prior authorization, if the costs exceed $1,000. If the workers’ compensation insurance carrier has notified you of a preferred provider of services, you must obtain services from that provider, unless the situation is an emergency or there is no preferred provider within a reasonable distance from where you live.

Medication

The cost of drugs to treat you condition are generally covered by workers’ compensation. The pharmacy may directly bill the workers’ compensation insurance company or you may seek reimbursement by sending the bill and a letter from your treating physician, indicating that the medication was a necessary part of your care.

Medical Benefits under a Workers’ Compensation Claim

Experienced NYC | Brooklyn | Bronx | Queens Workers’ Compensation Attorneys

At Pyrros & Serres LLP, we handle all matters related to workers’ compensation and Social Security disability claims for people in Queens, Brooklyn, the Bronx and across the greater New York City metropolitan area. Because of our reputation for effective advocacy, many of our new clients come to us as referrals from clients and other lawyers.

To learn more about the full scope of our practice, see our practice area overview page.

Pyrros & Serres LLP

Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

Why You Want an Experienced Workers’ Compensation Attorney to Handle Your Claim

You Want a Lawyer Well-Versed in the Complexities of Workers’ Compensation Law

attorney-michael-serresIf you’re an injured worker seeking benefits to cover lost wages or unreimbursed medical expenses, or you’ve developed an illness because of a jobsite exposure to toxic materials, it’s critical that you retain a lawyer with extensive knowledge, skill and experience handling workers’ compensation and workplace injury claims. The workers’ compensation process can be complex, even for legal professionals—the best chance of full financial recovery is with an attorney who understands the workers’ compensation process, who has successfully recovered benefits for other injured workers.

Here are some of the specific ways that a proven workers’ compensation attorney can help you or your client:

  • Properly developing and presenting medical evidence—One of the principal reasons many workers’ compensation claims are initially denied is because claimants offer insufficient or incomplete medical evidence. An experienced workers’ compensation attorney will know when it’s necessary to obtain an expert medical opinion, to depose medical experts or when medical records are missing something.
  • Development and introduction of vocational evidence—It’s not enough to show that you’ve suffered injury. You also need to show what the physical requirements are for your job and why you can’t meet them. This may require testimony about your daily activities or about current safety or training programs at you place of employment.
  • Negotiating a settlement, if appropriate—Unless your attorney has handled quite a few workers’ compensation claims, he or she won’t have a realistic idea of the value of your claim. An experienced workers’ compensation lawyer will be able to quickly look at your disability rating, whether it partial/total or temporary/permanent, and incorporate the costs of past and future medical expenses to determine the full extent of your losses.

 

Results-Oriented Workers’ Compensation Attorneys in Queens, New York

At Pyrros & Serres, we bring more than a half a century of combined workers’ compensation experience to injured workers in Queens and across the New York City metropolitan area. We built our reputation on personal service and attention, always taking the time to learn the details of your situation, so that we can tailor our representation to get the outcome you deserve. Many of our new cases come to us as referrals from our colleagues in the legal profession, from satisfied clients and from medical professionals.

We handle all types of work-related injury claims, including cases involving:

Occupational Disease or Illness | Hip, Leg, Foot and Toe Injury| Burns | Paralysis | Spinal Cord Injury | Permanent Scarring or Disfigurement | Amputation or Loss of Limb | Hearing or Vision Loss | Accidental Death | Back and Neck Injury | Traumatic Brain Injury (TBI) | Fractures | Shoulder, Arm, Hand and Finger Injury

 For more information about the services we provide, see our practice area overview page.

Pyrros & Serres LLP

Workers’ Compensation Attorneys—Queens, New York