NYC Workers Compensation Lawyers
Denied claim? Low benefit offer? We fight the insurance company at every stage of the workers comp process.
Workers Compensation in New York: Key Numbers
Fighting for Maximum Workers Comp Benefits in NYC
New York's workers compensation system is designed to provide medical treatment and wage replacement to injured workers, regardless of fault. In practice, insurance carriers routinely deny claims, send injured workers to biased medical examiners, and offer benefits well below what the law allows.
If your claim has been denied, your benefits cut, or your injury disputed after an IME, you are not without options. Our attorneys represent injured workers at every stage of the workers comp process: initial filings, contested hearings before the Workers Compensation Board, appeals, and settlement negotiations.
How Workers Comp Works in New York
Workers compensation is a no-fault system. You do not need to prove your employer was negligent. If you were injured while performing your job duties, you are entitled to benefits. The system provides four categories of benefits:
- Medical treatment: All reasonable and necessary medical care related to the work injury, with no copays or deductibles
- Wage replacement: Temporary total disability pays two-thirds of your average weekly wage, up to the statutory maximum
- Schedule loss of use (SLU): Lump-sum awards for permanent partial disability to specific body parts
- Death benefits: Surviving dependents receive weekly payments based on the deceased worker's wages
Your employer's insurance carrier administers the claim. The Workers Compensation Board oversees the process, resolves disputes, and ensures benefits are paid correctly. When the carrier disputes your claim, the Board holds hearings where a Workers Compensation Law Judge decides the outcome.
2025 Benefit Rate Table
| Injury Date | Max Weekly Rate | Min Weekly Rate |
|---|---|---|
| July 1, 2024 - June 30, 2025 | $1,183.64 | $325.00 |
| July 1, 2023 - June 30, 2024 | $1,145.43 | $275.00 |
| July 1, 2022 - June 30, 2023 | $1,125.46 | $275.00 |
| July 1, 2021 - June 30, 2022 | $1,063.05 | $275.00 |
| July 1, 2020 - June 30, 2021 | $966.78 | $150.00 |
| July 1, 2019 - June 30, 2020 | $934.11 | $150.00 |
Source: New York Workers Compensation Board, Maximum Benefit Rate Schedule
Common Reasons Claims Get Denied
Insurance carriers deny workers comp claims for many reasons. Some denials are legitimate. Many are not. The most common grounds for denial include:
- Insurance carrier disputes that the injury is work-related
- Employer denies the accident occurred
- Late reporting: you must report within 30 days and file within 2 years
- IME doctor finds no disability or attributes symptoms to a pre-existing condition
- Gaps in medical treatment used to argue recovery
- Employer claims the injury happened outside of work
- Failure to attend scheduled IME appointments
A denied claim is not the end of your case. It is the beginning of the contested claim process. Our attorneys file hearing requests, gather supporting medical evidence, and present your case before the Workers Compensation Board.
The IME Problem
Insurance carriers select and pay the doctors who conduct Independent Medical Examinations. These examinations often last 5 to 10 minutes and conclude with findings that minimize or deny your disability. The IME doctor's report becomes the carrier's primary evidence for reducing or cutting your benefits.
You have rights in this process. Bring a witness to the examination. Request a copy of the IME report. Present your own treating physician's contradicting findings at the hearing. An experienced attorney can cross-examine the IME doctor at the hearing and expose inconsistencies between a 7-minute exam and months of documented treatment.
Protect Your Claim: Your Doctor Matters
Your treating physician's opinion carries significant weight at WC Board hearings. Make sure your doctor provides detailed, objective reports documenting your injury, treatment, and disability status. Vague notes like "patient has pain" do not hold up against a detailed IME report. Specific findings, measurements, and functional limitations win cases.
Workers Compensation Board Hearings
Hearings are conducted by Workers Compensation Law Judges (WCLJs) at Board offices across New York, including the main office at 199 Church Street in Manhattan. The hearing process addresses several issues: establishing the claim, determining the degree of disability, resolving disputes between your doctor and the IME doctor, and setting benefit rates.
A judge can order the carrier to pay benefits, approve settlements, or schedule additional hearings for further evidence. Most contested cases require multiple appearances over several months. Legal representation at these hearings significantly impacts outcomes. Carriers bring experienced defense attorneys to every hearing. You should have experienced counsel as well.
If the judge's decision is unfavorable, you can appeal to a three-member Board Panel. Further appeals go to the Appellate Division, Third Department. Each stage has strict deadlines. Missing a filing deadline can forfeit your right to appeal.
When You Also Have a Third-Party Claim
Workers comp is not always the only option. If a third party (not your employer) caused your injury, you may have a separate personal injury lawsuit. This is common in construction accidents, car accidents during work, and injuries caused by defective equipment. Third-party claims allow recovery for pain and suffering, which workers comp does not cover.
Pursuing both avenues simultaneously often makes sense for serious injuries. Workers comp provides immediate benefits while the third-party lawsuit seeks full compensation including pain and suffering, full lost wages, and future earning capacity.
Learn more about workplace injury and third-party claims
Mental Injury Expansion: June 2025
Starting June 2025, all New York workers can file workers comp claims for mental injuries, including PTSD and work-related psychological conditions. Previously, only first responders were eligible for mental injury claims. This expansion covers workplace violence, harassment-related trauma, and other psychological injuries sustained on the job.
Source: Governor Hochul, S755/L1677
Related Practice Areas
- Workplace Injuries: Third-party claims, Labor Law protections
- Construction Accidents: Scaffold Law, Labor Law 240 claims
- Slip and Fall: Workplace premises liability
Related Guides and Analysis
- Workers' Comp vs. Third-Party Claims in New York
- Workers' Comp Benefits 2025: What Changed and What It Means
New York Workers Compensation Board. Injured workers' rights and responsibilities.
https://www.wcb.ny.govNew York Workers Compensation Board. Maximum benefit rate schedule.
https://www.wcb.ny.gov/content/main/Workers/ScheduleMaxWeeklyBenefit.jspNew York Workers Compensation Law Section 120. Anti-retaliation protections.
https://www.nysenate.gov/legislation/laws/WKC/120Frequently Asked Questions
How much will I receive in workers comp benefits?
Benefits depend on your average weekly wage and the severity of your injury. The maximum weekly rate for 2025 injuries is $1,183.64 for total disability. Temporary partial disability pays two-thirds of the difference between pre-injury and post-injury wages, capped at the same maximum.
My workers comp claim was denied. What can I do?
File an application with the Workers Compensation Board requesting a hearing. Many denials are based on the insurance company's IME doctor finding no disability or disputing that the injury is work-related. An experienced attorney can challenge these findings, present supporting medical evidence, and advocate at the hearing.
What is an IME and do I have to go?
An Independent Medical Examination is a medical evaluation requested by the insurance carrier. Despite the name, these doctors are selected and paid by the insurer. You must attend or risk losing benefits. You have the right to bring someone with you and to request a copy of the report.
Can I choose my own doctor for workers comp?
Yes. New York law allows you to choose your own physician as long as the doctor is authorized by the Workers Compensation Board. Your doctor's findings carry significant weight, especially when they contradict the insurance company's IME report.
How long does a workers comp case take?
Simple accepted claims may resolve in months. Contested cases involving denied claims, multiple hearings, and disputes over disability classification can take one to three years. Cases requiring a schedule loss of use (SLU) evaluation are typically resolved after you reach maximum medical improvement.
Can I be fired for filing a workers comp claim?
New York Workers Compensation Law Section 120 prohibits employers from retaliating against employees who file claims. If you are terminated, demoted, or harassed for filing, you may have grounds for a retaliation claim in addition to your workers comp case.
What if my employer doesn't have workers comp insurance?
You can file a claim with the Uninsured Employers Fund administered by the Workers Compensation Board. The employer faces criminal penalties and fines of up to $2,000 per 10-day period without coverage. You retain all rights to benefits.
Do I need a lawyer for workers comp?
While not legally required, representation significantly improves outcomes for contested claims. Insurance companies have experienced attorneys. A workers comp lawyer levels the playing field, handles hearings, challenges IME reports, and ensures you receive the maximum benefits available.