New York Workers' Compensation Laws

People get hurt at work. It happens. Most workplace injuries are minor, and the employee is out for only a short time. When the accident is more serious, the worker may require significant medical treatment. In that case, they can file a workers’ compensation claim.

If your employer and their workers’ compensation insurance carrier approve your claim, they’ll cover your medical expenses. Depending on how long you’re unable to work, you may also receive replacement wages. You’ll continue to receive workers’ compensation benefits until you recover or reach “maximum medical improvement.”

This article examines and explains how workers’ compensation works in the state of New York. It also discusses the types of benefits you’ll receive and what happens when your workers’ comp claim ends.

If you’ve suffered a workplace accident or occupational illness and your employer has denied your workers’ comp claim, consider seeking legal advice from an experienced New York workers’ compensation lawyer. They’ll review your case and fight to get you the benefits you deserve.

Who Is Eligible for Workers’ Compensation in New York?

Almost all workers are eligible for workers’ compensation in New York. New York workers’ compensation laws require that all employers with at least one employee maintain workers’ compensation coverage. This applies to companies with full-time and part-time employees. Even seasonal workers qualify.

There are exceptions to this rule. Certain categories of workers are not entitled to workers’ comp benefits. People who fall into the following categories do not qualify for workers’ compensation in New York:

• Sole proprietors
• Partners in a business
• Federal employees
• Railroad employees
• Domestic workers
• Most agricultural workers
• Independent contractors/consultants

If a business owner fails to carry the required insurance coverage, they may face fines, penalties, and even stop-work orders.

When Should You File a Workers’ Compensation Claim?

Workers’ compensation is meant to help cover medical bills and lost wages for injured workers. To qualify for workers’ compensation benefits, you must demonstrate that your injuries are work-related. If your accident occurred at work and on company property, your workers’ compensation claim has a good chance of being approved.

Employees shouldn’t have to pay out of pocket for medical costs related to a workplace accident or illness. They shouldn’t lose money as a result of the accident.

Not every injury suffered at your place of employment will qualify for workers’ comp. You’re unlikely to receive approval for workers’ comp benefits if any of the following apply:

• Your accident or injuries took place on personal time
• You were under the influence of drugs or alcohol at the time of the accident, and this impairment is what caused your injuries
• You have a pre-existing condition that is the underlying cause of your injuries
• You were not on the clock when injured
• You weren’t on company property or engaged in a work-related activity at the time of your workplace injury

If you aren’t sure whether it’s in your best interest to file a claim, talk to a New York workers’ comp attorney. They’ll review your situation and advise you on how best to proceed. If you file a claim and the New York Workers’ Compensation Board denies it, you can appeal.

Filing a Workers’ Compensation Claim in New York

You must file a workers’ compensation claim within the state’s statutes of limitations. If you don’t, your employer or their insurance company may deny your claim. This means paying your medical costs yourself.

The workers’ compensation claim process in New York is as follows:

• You must seek immediate medical attention for any injuries you suffer during a workplace accident. If no medical professionals are on site, request EMTs or go to an emergency room.
• After you receive emergency medical care, report your workplace injury or illness to your manager or the Human Resources department. This must be done within 30 calendar days of your accident to qualify for workers’ comp benefits.
• You must receive medical treatment from a healthcare provider authorized by the New York State Workers’ Compensation Board. If your employer participates in a certified Preferred Provider Organization (PPO) or Alternative Dispute Resolution (ADR) program, you may be required to choose a doctor within that network. After 30 days, you may transfer your care to your own provider.
• When you report your accident to your employer, they must file form C-2F (Employer’s Report of Work-Related Injury/Illness). They also must provide you with a copy.
• Your employer may choose to dispute your workers’ compensation claim. If so, it must issue form C-7 (Notice of Controversy) to you within 18 days after the disability begins OR within 10 days after receiving knowledge of the alleged accident, whichever period is greater.
• If your employer denies your claim, you can file a request for benefits with the New York Workers’ Comp Board. You can access information or file a claim at the Board’s website.

You have two years from the date of your injury (or the date your employer files its “First Notice of Injury” form) to file your New York Workers’ Compensation Claim with the WCB.

The claims process can be overwhelming, especially if you’re dealing with a serious injury or illness. Ideally, your employer’s New York workers’ compensation insurance will pay your claim. If your employer was reckless or intentionally caused your injuries, you may be able to file a claim under their employers’ liability insurance policy. An experienced New York personal injury attorney can help you with either process.

What Benefits Are Available Under Workers’ Compensation in New York?

If the insurance company approves your workers’ comp claim, you’ll receive several types of benefits. Your medical care will be covered by the insurance carrier. As long as the medical treatment is directly related to your workplace accident and is reasonable and necessary, the insurance company shouldn’t object to paying the medical costs.

In addition to medical care, you’ll also receive replacement wages. If you miss more than three days of work, you can collect compensation for your lost wages. You’ll receive 2/3rds of your average weekly wages.

Should your workplace accident leave you partially or totally disabled, you may also be entitled to disability benefits. Let’s take a closer look at some of the most common types.

Medical Benefits

Employers are required by law to carry workers’ comp insurance to cover injured employees’ medical bills. As long as your medical treatment is reasonable and necessary, workers’ comp should cover it. This coverage will continue until you return to work or reach “maximum medical improvement.”

Some of the medical care covered by workers’ compensation includes:

• Emergency room visit
• Ambulance ride
• Hospitalization
• Prescription medications
• Physical therapy
• Vocational rehabilitation
• Chiropractic care (in some cases)
• Medical devices/medical equipment

If the insurance company refuses treatment or refuses to pay your medical bills, let your New York workers’ comp lawyer know right away.

Replacement Wages

Workers’ comp covers a large part of your lost wages due to injury. The amount of your weekly benefits depends on your income. You’ll receive 67% of your average weekly wages (AWW). To calculate your AWW, add your wages for the last 52 weeks, then divide the total by 52. Multiply that amount by 0.67 to determine what you’ll receive each week of coverage.

New York law caps the amount you can receive through workers’ comp each week. The maximum benefit rate for 2026 is $1,281.50 per week. Even if your weekly benefit rate would be much higher, it’s the most you can receive in any given week.

Death Benefits

Some workplace accidents or occupational illnesses are so serious that the worker dies as a result of their injuries. If this happens, the employee’s spouse and/or dependents may be entitled to the weekly benefits their loved one would have received had they survived. In addition to weekly benefits, the decedent’s family will also receive reimbursement for burial or funeral expenses.

Who Decides When You Return to Work?

New York employers must pay their employees weekly disability benefits until they are ready to return to work. In some cases, the employee can never return to work full-time or even part-time. In these cases, your New York workers’ comp attorney will fight to get you permanent disability benefits.

In most cases, the employee recovers enough to go back to work. This happens when, in the employee’s workers’ comp doctor’s opinion, they have reached “maximum medical improvement (MMI).

MMI occurs when your workers’ compensation doctor determines that further treatment will not improve your condition. If you disagree with your doctor’s assessment and don’t think you’re ready to go back to work, you can ask for a second opinion. Your attorney can arrange an Independent Medical Examination (IME), which allows you to be examined by a different doctor. If the IME shows you need further treatment or are permanently and totally disabled, your attorney can challenge the insurance company’s findings.

What if You’re Permanently Disabled After Your Workplace Accident?

If you end up permanently disabled (partial or total) after your workplace accident, you may be entitled to significant compensation. New York categorizes permanent disability awards based on the body part affected. For example, a foot injury will be worth less than a back or neck injury.

When determining your permanent award, the insurance company will look to see how many weeks your body part is worth. It will then multiply the number of weeks by your percentage of disability. It then multiplies that number by your weekly benefit rate. In most workers’ compensation cases, the claimant (and their attorney) negotiates a lump sum settlement rather than waiting and collecting weekly payments for months or years on end.

What if the Insurance Company Denies Your Claim?

Most workers’ comp claims are approved without issue. If the insurance company denies your claim, you have the right to file an appeal. The appeals process can be intimidating, and you only get one chance to get it right. It’s a good time to consider working with a New York workers’ compensation attorney to help with your appeal.

The appeals process in New York is rather formal. If you don’t follow the proper steps, the New York Workers’ Compensation Board will deny your appeal. You’ll lose your opportunity to receive benefits.

Legally, you have 30 days from the date of your “Notice of Denial” to file your appeal. Before you begin filling out your appeal paperwork, make sure you know what the reason was for the denial. This information is clearly stated on your “Notice of Denial.”

Disclaimer: State laws are subject to change due to new legislation, higher court rulings, and other means. While we strive to provide the most current information, consult a New York workers’ compensation attorney or conduct further legal research to verify your state laws.

Seek Legal Advice Regarding Your New York Workers’ Compensation Claim

If you suffer an injury at work and aren’t sure how to file a workers’ compensation claim, contact a local workers’ comp attorney. The New York workers’ compensation system and claims process can be complex and overwhelming, especially while you’re recovering from a work-related injury.

Ideally, your employer will approve your claim and cover your medical expenses. If they deny your claim, you won’t receive reimbursement for your out-of-pocket medical bills or receive replacement wages. An experienced New York workers’ compensation attorney will review your claim and, if warranted, help you file an appeal. They will also fight to get you the benefits you and your family members deserve.