How Does Workers’ Comp Work?

How Does Workers’ Comp Work?

Being injured at the workplace can be frustrating and worrying, not to mention painful. For many New York workers, being injured on the job can result in not only a loss of income during recovery but also potentially overwhelming medical expenses and other financial complications.

That’s where workers’ compensation comes in. Workers’ compensation, or “workers’ comp” for short, is a type of insurance your employer is likely required to hold. Through workers’ compensation, you could be entitled to monetary benefits to compensate you for medical bills, time spent away from work, and more.

Let’s explain how workers’ comp works, what it means for you, and how to file a claim. If you’ve already been injured and want to speak to a knowledgeable legal expert in person, contact Schwartzapfel Lawyers today at 1-516-342-2200 or online for a free consultation.

What Is Workers’ Comp?

Workers’ compensation is a type of workplace insurance that must be maintained by most employers in New York State. In a nutshell, workers’ comp pays workers who are injured on the job or in the course of their job-related duties to compensate them for medical bills and other accident-related expenses.

For example, imagine being injured while working at a construction site. You fall down a ladder, breaking your leg. Since the injury occurred at the workplace, you may be eligible for workers’ compensation benefits.

Workers’ comp benefits are meant to pay for work-related injurymedical treatments, including extended medical care if needed. Furthermore, if you are permanently disabled, you may be eligible for disability benefits according to workers’ compensation law. In addition to medical expenses, your workers’ comp benefits may cover other items, such as lost income due to time away from work.

Note: Workers’ comp is not a punishment to companies or employees. Moreover, you do not need to prove that your employer did anything wrong to recover workers’ comp payments. So long as you sustain a workplace or work-related injury, you may qualify for workers’ comp payouts.

Who Pays for Workers’ Comp Insurance?

Employers pay for workers’ comp insurance. Like other insurance policies, employers pay premiums to workers’ compensation companies. In exchange, they don’t have to pay the medical bills or other accident-related expenses that employees may incur after a workplace accident.

Workers never have to pay for their own workers’ comp insurance under any circumstances, nor do they need to pay fees when filing claims. The insurance carrier handles the claims process and provides payments to dependents in the event of death benefits, but your insurance coverage will likely not require reimbursement on your part.

The cost of workers’ compensation insurance can vary greatly depending on a number of factors, including but not limited to:

  • The industry in which the business operates.
  • Where the business is located.
  • The number of employees and whether they are full or part-time.
  • The company’s payroll.
  • The history of workers’ comp claims and safety incidents at a given company (Note: Generally, the more accidents there are, the higher the company’s insurance premium will be).

Companies are not allowed to pass any of the workers’ comp insurance costs on to their employees. For instance, if an employee sustains a work injury, and all other workers receive a pay cut allegedly because of insurance, that’s illegal. Those workers may have grounds for a class-action lawsuit against their employer.

Are Companies Required to Have Workers’ Comp Insurance?

According to New York State law, the majority of employers have to have some type of workers’ compensation insurance policy. There are very few exceptions to this. If an employer does not have workers’ comp insurance but is required to have one under New York law, they could be subject to heavy penalties and fines later down the road.

Learn more about workers’ comp by contacting Schwartzapfel Lawyers now at 1-516-342-2200 or by scheduling a free consultation online today.

How Does Workers’ Comp Work if a Worker Is Injured?

Now let’s take a closer look at how exactly a workers’ comp situation plays out. Start with a hypothetical example: an employee is injured at the workplace.

An Employee Files a Claim

After being injured and receiving medical attention, the employee files a workers’ comp claim with their employer. The claim is filed with the worker’s company, not the insurance company itself. In essence, the employer passes the claim on to the insurance company, but most employees just have to provide their H.R. departments or managers with their claims.

Your company should assist you in filling out the right paperwork and filing the claim. If you have questions about your workers’ comp coverage, you should be able to ask your employer and get the answers immediately. Alternatively, contact knowledgeable workers’ comp attorneys.

A Workplace and Insurer Investigate the Claim

After receiving an employee’s workers’ comp claim, the workplace, and the insurance company may investigate it depending on the circumstances. Some employees may try to abuse workers’ comp payouts by faking injuries, for example.

In most cases, however, the investigation is brief and cursory. An employer may simply check camera footage to make sure the injured worker was truly injured by accident and to ensure that they were not violating any safety procedures when they were hurt.

If everything checks out, the insurance company will likely complete the claim and receive the injured worker’s contact and financial information.

The Employee Receives Compensation

Once the claim goes through, the injured employee should begin receiving compensation payments shortly thereafter. As well, they may also be eligible to receive vocational rehabilitation and/or additional monetary compensation if the injuries are deemed permanent in nature.

Note: Most workers’ comp payments are provided monthly, although some payments may be awarded in larger lump sums. This is especially true of payments that are technically back pay due to time where the employee should have received workers’ comp but did not because of slowness in processing or other factors.

What Happens if an Employer Refuses to Accept a Workers’ Comp Claim?

The majority of employers accept workers’ comp claims without difficulty. They know that their employees don’t deliberately try to hurt themselves or violate safety procedures. Still, some employers may not accept workers’ comp claims for reasons such as:

  • They may not have workers’ compensation insurance, in which case they are likely violating New York State law.
  • They don’t want their premiums to rise. Each time they file a claim, they will likely see a short-term bump in their policy payments, similar to other insurance types.
  • They don’t believe the employee or think that the employee deliberately injured themselves.

In all these circumstances, it can be difficult for the injured employee to get the financial coverage they need to pay for medical bills, compensate them for time spent away from work, and more.

If your employer does not accept your workers’ comp claim for whatever reason, contactSchwartzapfel Lawyers at 1-516-342-2200 right away. Our knowledgeable attorneys can provide you with a variety of assistance, including but not limited to:

  • Providing sound legal counsel throughout the duration of your case.
  • Negotiating with your employer or insurance companies on your behalf.
  • Helping you gather evidence proving that you were injured on the job and without violating company policies.
  • Fighting for you in and out of court.

Contact Schwartzapfel Lawyers Today

Workers’ comp is a business insurance policy that practically all New York employers are required to carry. Through workers’ compensation, employees receive financial compensation if they suffer injuries at the workplace or while in the performance of work-related duties. As a process, employees file workers’ comp claims, then receive compensation based on information related to such items as medical bills, the nature of the accident, and beyond.

In most cases, employers should be willing to help file workers’ comp claims without trouble. But if you are prevented from getting the compensation you are entitled to, you may need legal assistance.

Skilled workers’ comp attorneys like the team at Schwartzapfel Lawyers can help you in more ways than one. Contact us at 1-516-342-2200 for a free consultation, case evaluation, and so much more. It would be our honor and privilege to fight for you – day or night, rain or shine.

But you shouldn’t wait, as your window to file a claim and recover the money and benefits you are entitled to may soon close forever. To keep that from happening, call Schwartzapfel Lawyers now at 1-516-342-2200 or visit us online today!

DISCLAIMER: Nothing on this page should be considered legal advice. You should seek the appropriate counsel your situation requires. For more information, call 1-516-342-2200 now!


Schwartzapfel Lawyers, P.C. | Fighting For You

What is Workers’ Compensation? | Workers’ Compensation Board of New York

Workers’ Compensation | U.S. Department of Labor (

Workers’ Compensation Coverage Requirements | Workers’ Compensation Board of New York

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