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Who is Eligible |
How
to File a Claim |
|
With few
exceptions, nearly all workers in this State are
covered. In addition, nearly all organized
volunteers, such as members of volunteer fire and
ambulance corps are covered. |
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Report your
injury to the employer promptly (must be
within 30 days of accident)
-
Obtain Board
Form C-3, Employee's Claim for
Compensation, from CSEA Workers'
Compensation Legal Assistance Program by
calling CSEA Headquarters during normal
business hours, 8 a.m. - 5 p.m., M-F, at
1-800-342-4146, and follow the menu
instructions for the Workers' Compensation
Legal Assistance Program.
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| If you have
a possible Workers' Compensation or Social Security
Disability case, the CSEA Workers' Compensation Legal
Assistance Program will provide you with honest, courteous
and professional representation, at no out-of-pocket cost
to you. The representation is provided by the firm
of FINE, OLIN, AND ANDERMAN, P.C., through
it's statewide network of offices staffed by attorneys who
specialize in Workers' Compensation / Social Security Law. |
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| What
is Workers' Compensation? |
Workers' Compensation
is insurance, paid for by the employer, that
provides cash benefits and medical care for workers
who require medical care or become disabled because
of a job-related injury, sickness or occupational
disease. Some employers are self-insured.
|
|
What
About Medical Care? |
- You are free to choose
any doctor authorized by the Workers'
Compensation Board, unless your employer
is participating in the New York State
Managed Care for Workers' Compensation
Pilot Program.
- You do not pay the
doctor. The doctor is paid by your
employer or his insurance carrier.
|
Will I
Get Any Cash Compensation? |
| Yes, If you're
totally or even partially disabled, you may
receive as much as two-thirds of your average
weekly wage. Under present tax laws
these payments are tax free.
Injuries to certain parts of
the body may entitle you to a substantial cash
award, even without the loss of a single day
from work. But failure by your treating
physician to file a "C-4" (medical
report) with the Workers' Compensation Board
and your employer, or it's insurance carrier,
may delay payments.
|
What
About Death Benefits? |
If a worker dies
from a compensable injury or illness, the
surviving wife, husband or dependents are
entitled to weekly cash benefits under the
Law. Funeral expenses are payable, in
whole or in part, depending on the amount of
the bill.
- Obtain emergency medical
treatment, if needed.
- Note the location of the
accident site and names of witnesses.
- Report the accident to
your supervisor. If required, file
an accident or incident report.
- Place yourself under the
care of a medical practitioner who treats
Workers' Compensation cases.
- Contact the CSEA Workers'
Compensation Legal Assistance Program at
1-800-342-4146 for help in preparing and
filling your claim with the Workers'
Compensation Board. When you call,
be sure to have answers for the Intake
Form as appears below:
CSEA
Workers' Compensation Legal Assistance Program
Intake Form
-
NAME
-
ADDRESS
-
HOME
PHONE
-
WORK
PHONE
-
SS #
-
BIRTH
DATE
-
ACCIDENT
DATE
-
DETAILS
OF ACCIDENT
-
ADDRESS
OF ACCIDENT
(including county)
-
PARTS OF
BODY INJURED
-
NAME OF
EMPLOYER
(agency/facility/etc)
-
EMPLOYER'S
ADDRESS
-
CSEA
LOCAL/UNIT #
-
WITNESSES
TO ACCIDENT
-
TIME LOST
FROM WORK
-
SALARY OR
BENEFITS RECEIVED
DURING ABSENCE
-
WEEKLY
PRE-TAX SALARY
-
JOB TITLE
-
ADDITIONAL
EMPLOYERS
-
W.C.B. #
ON FILED CLAIM
-
INSURANCE
COMPANY AND CASE #
-
NAME/ADDRESS
OF REPRESENTATIVE
(if any)
-
HEARINGS
TO DATE IN THIS MATTER
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