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If you or a loved one is recovering from a workplace injury, you’re likely counting on your workers’ compensation benefits to cover bills and lost wages. So, what happens if you receive a letter telling you the insurance company is demanding that you pay back some or even all of the benefits you’ve received?

Many injured workers face these demands, so you’re not alone if this happens to you. Most of the time, full repayment is rare. However, you need to know why you would have to pay back workers’ comp to ensure the request is fair and enforceable.

And so, if you or a loved one has been asked to repay workers’ comp, please don’t panic. You’re not alone. Instead, call the experienced New York workers’ comp attorneys at Schwartzapfel Lawyers at 516-342-2200 for a free consultation and so much more. 

Over the past forty (40) years, we’ve successfully helped countless injured workers through difficult situations and can help you better understand your legal options today. If, however, you would prefer to read up on the subject first, please continue.

Do You Have To Pay Back Workers’ Comp In New York?

Sometimes, the circumstances surrounding your injury or the benefits you’ve received change. If you end up receiving more compensation than you were truly entitled to, you might have to pay back a portion. This happens to prevent what’s called “unjust enrichment,” in which someone profits unfairly from a situation.

Remember, workers’ compensation is here to provide fair compensation for your injuries and lost income, not to make you richer. It’s a balancing act, and sometimes the government needs to make adjustments.

To this end, if you’re unsure whether you’re liable for repayment, our seasoned attorneys can review your case for free and provide the clarity you need. Simply contact Schwartzapfel Lawyers at 516-342-2200 today!

What Are Common Reasons For Workers’ Comp Repayment In New York?

Several situations can trigger a request for repayment of workers’ compensation benefits. Let’s break down the most common ones:

Third-Party Lawsuits

Your workplace injury might be caused by someone other than your employer or a coworker. For instance, a construction worker could be injured by a faulty scaffold provided by another company. In such cases, you might have grounds for a personal injury lawsuit against that third party.

However, if you win that lawsuit or reach a settlement, the workers’ compensation insurer may be entitled to some of that money because they paid out benefits for an injury that was ultimately someone else’s responsibility. This right to reclaim a portion of the money is known as “subrogation.”

Don’t worry! Your workers’ compensation benefits won’t necessarily disappear entirely. They may continue at a lower rate after the insurer recoups their portion of your winnings.

Fraudulent Claims

When someone lies or intentionally misleads the workers’ compensation system to get benefits they haven’t earned, it’s called fraud. Fraud can range from completely fabricating an injury to downplaying how it happened to make it seem work-related.

It’s important to understand that the insurance company can’t just accuse you of fraud and expect to win. They must provide solid proof that you deliberately lied to them.

The consequences of fraud can be serious, even leading to criminal charges in some cases. Being truthful from the beginning is always the best course of action.

Mutual Mistakes

Mistakes happen, and sometimes, those mistakes can affect your workers’ compensation benefits. A common example is an error in calculating your average weekly wage.

If this figure is higher than it should be, you may receive more benefits than you’re legally entitled to. The insurer will likely ask for the overpayment to be returned, but it’s usually a straightforward adjustment.

For more on this and related topics, call Schwartzapfel Lawyers at 516-342-2200 or schedule your free consultation with us online today. Alternatively, please continue reading.

Unreported Changes In Circumstances

New York labor law requires you to report certain changes in your situation to the workers’ compensation insurer. These include returning to work, earning income from other sources, or being incarcerated.

Failing to report these changes can lead to repayment demands, as you might be receiving benefits you’re no longer eligible for.

Voluntary Or Overpayments

An insurer might make an administrative error and pay you more than they intended. This can happen due to a simple mistake or a misunderstanding of the facts of your case.

These issues are generally easier to resolve than other repayment situations, but it’s still wise to consult with a knowledgeable attorney to ensure a fair outcome.

What Should You Do If You’re Asked to Repay Workers’ Comp In New York?

Receiving a letter demanding repayment of your workers’ compensation benefits can feel like a punch to the gut. Thankfully, there are steps you can take to protect your rights and potentially avoid repayment altogether.

Hire A Skilled Lawyer

The absolute first thing you should do is contact an experienced workers’ compensation lawyer. That’s because you should not try to handle this situation alone. A skilled lawyer with experience in this area can make a world of difference.

Here, Schwartzapfel Lawyers comes equipped with over (150) years of combined experience successfully helping injured workers just like you in New York and beyond. Our seasoned attorneys know the ins and outs of the workers’ compensation system, and we’re ready to use that knowledge for you. Call now!

How Can A Skilled Lawyer Help?

Your seasoned workers’ comp lawyer is your guide through all the ups and downs of workers’ compensation benefits and claims. To illustrate, the right workers’ comp attorney can help the success of your claim in ways including but not limited to:

  • Thorough Case Review: They’ll carefully examine every detail of your case, looking for any errors the insurer may have made, laws they may have misinterpreted, or facts they might have overlooked.
  • Negotiation Power: Your skilled lawyer can communicate with the insurance company on your behalf. They know how to negotiate effectively and can often reach agreements that are more favorable to you than what you could achieve on your own.
  • Advocacy: If necessary, your seasoned lawyer can file a claim with the Workers’ Compensation Board, presenting a strong case on your behalf. They’ll fight to protect your rights and ensure you get the compensation you deserve.

Note: If it turns out that you do need to pay back some benefits, your qualified lawyer can help you look into the different repayment options. These might include:

  • Credit Against Future Benefits: If you’re still receiving benefits, the insurer can deduct the owed amount from future payments.
  • Lump Sum Payment: You may have the option to pay back the entire amount in one go. However, this can be a financial burden, so it’s important to consider carefully.
  • Negotiated Reduction: Sometimes, it’s possible to negotiate a reduced repayment amount with the insurer. This is where having a skilled lawyer can be a huge advantage.

Facing a workers’ comp repayment demand is intimidating, but you don’t have to go through it alone. With the right legal team by your side, you can confidently face the situation and achieve the best possible outcome.

To that end, Schwartzapfel Lawyers is ready and able to help you today. Call us now at 516-342-2200 for a free consultation and allow our award-winning team the honor and privilege of fighting — and winning! — for you.

Don’t Pay Back More Than You Owe

While workers’ compensation insurers have a right to recoup overpayments, they don’t always get it right. Sometimes, they might demand more money back than you legally owe or pressure you to repay sooner than necessary. This could be due to honest mistakes, aggressive tactics, or even attempts to take advantage of your situation.

For instance, an insurer might miscalculate the amount you were overpaid, overlooking certain deductions or credits you’re entitled to. They could also try to pressure you into a quick repayment, hoping you won’t take the time to understand your rights or seek legal counsel.

In some cases, insurers may even use scare tactics or misleading information to get you to pay up. One way is they might threaten to withhold future benefits or take you to court. No matter what, though, remember that you have rights. You don’t have to fall victim to such tactics.

That’s where having an experienced workers’ compensation lawyer on your side becomes invaluable. At Schwartzapfel Lawyers, we’ll carefully review your case as well as the insurer’s demands. Moreover, we’ll make sure that repayment calculations are accurate and fair.

We’ll also resist unreasonable deadlines and aggressive tactics in order to protect your rights and maintain the quality of your claim. So, please, don’t let the insurance company bully you into paying more than you owe. Instead, protect your financial future by calling Schwartzapfel Lawyers at 516-342-2200 or by scheduling your free consultation online today.

Let Schwartzapfel Lawyers Fight For You!

Depending on the circumstances of your claim, you might be required to repay workers’ compensation benefits for any number of reasons. And so, it goes without saying that workers’ comp repayment is a complicated issue.

Equally so, it can be said that, when dealing with workers’ comp or personal injury claims, it’s easy to feel overwhelmed or unsure of what to do next. That’s why getting sound legal advice without delay is so crucial.

In sum: The sooner you have an experienced lawyer on your side, the better your chances are of resolving the situation in your favor.

Please, don’t let uncertainty or fear of your situation hold you back. At Schwartzapfel Lawyers, we understand the stress and worry that comes with any repayment demand.

What’s more, we’re here to help you through it. One phone call could save you miles of headache, heartache, and financial strain down the road. Call us now at 516-342-2200 for a free consultation and ample peace of mind.

No matter your situation, it will be our honor and privilege to fight — and win! — for you. Act today to protect your tomorrows. Call now and stress less!

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

Sources:

Schwartzapfel Lawyers, P.C. | Fighting For You

unjust enrichment | Wex | US Law | LII / Legal Information Institute

Office of the Workers’ Compensation Fraud Inspector General | NY.gov

Workers’ Compensation Issue Resolution – An Introduction | NYS WCB

8: Case Review | United States Department of Justice

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