New York Staff Compensation Insurance coverage Legal guidelines – Forbes Advisor

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Workers’ compensation insurance pays for medical care, lost wages and other benefits if you become ill or injured as a direct result of your work.

Each state has its own employee compensation laws. Here’s a look at the laws in New York.

What is New York Workers Comp. covered?

New York workers’ compensation insurance pays medical treatment for an injured or sick employee, lost wage benefits, and survivor benefits.

Medical services in New York cover:

  • Medical supplies
  • dental care
  • surgery
  • Optometry
  • Medically necessary drugs

In New York, except for emergencies, the healthcare provider treating you must be authorized by the Workers Compensation Board to treat injured or sick workers.

Workers Comp pays a portion of your lost wages if your injury or illness affects you in any of the following ways:

  • It keeps you from work for more than seven days
  • Your wages will be cut because you now work fewer hours or do other work

If an injured worker dies of work-related injury or illness, the surviving spouse and family are entitled to weekly cash benefits. The amount is two thirds of the average weekly wage of the deceased employee in the 52 weeks prior to the injury or illness.

Funeral expenses are also covered by employee compensation insurance in New York.

Where can you get workers compensation insurance in New York?

In New York, workers’ compensation insurance can be obtained through an insurance company, insurance broker, or through the New York State Insurance Fund.

The New York State Insurance Fund is a New York State not-for-profit agency. This fund must offer workers’ compensation insurance to any employer seeking coverage, regardless of the type of company, safety record or company size of the employer.

Largest Workers Comp Insurance Company in New York

Filing a New York Employee Compensation Claim

In New York, you must notify your employer of any employee compensation claim within 30 days of the illness or injury. If 30 days have passed and you have not done so, you may lose your right to employee compensation.

You should also file an employee claim with the Workers Compensation Board in New York as soon as possible. To fill out this form, you will need to provide:

  • Name and address of your employer
  • The dollar amount of gross wage paid per pay period
  • The names and addresses of all other employers for whom you were working at the time of your injury or illness
  • Name and address of the doctor or hospital that carried out your initial treatment

Types of Employees That Are Covered

Under the New York Workers’ Compensation Act, most people who provide services to a for-profit corporation are considered employees of that corporation. An employee can be:

  • Part time
  • Full time
  • Temporarily
  • Seasonal
  • Casual / day work
  • Unpaid, including volunteers and family members

All of these types of workers must be covered by workers’ compensation insurance from a New York employer.

Make sure your employee’s insurance company’s underwriter is using the correct classification for your employees. Improper classification could increase your employee compensation award.

Types of nonprofit employees excluded

Non-profit organizations that pay individuals for their services are required to take out workers’ compensation insurance for all employees – with a few exceptions:

  • Clergy and members of religious orders who perform religious duties
  • Members of regulated amateur sports activities that operate on a non-profit basis
  • Teachers teaching for a nonprofit identified as a religious, charitable, or educational organization under the IRS Code
  • People who receive charitable help from a religious or charitable institution and do a job for it

Penalties for lack of employee insurance in New York

Penalties for non-compliance with employee compensation insurance in New York can be up to $ 2,000 for any 10-day period without insurance. Because of this, when an employer receives their first penalty notice, the fine can exceed $ 12,000.

A company has 30 days from the date of the first fine notice to request a review of the fine notices. A company also has the option to explain why there was an insurance default and request a reduction in the penalty for non-compliance. This review could result in the sentence being reduced or maintained, depending on the decision of the New York State Workers Compensation Board.

Medical treatment as part of the Workers Comp. receive

If an employee becomes ill or injured, the employee should immediately inform his employer or supervisor and seek medical treatment. The healthcare provider you choose must be authorized by the New York State Workers Compensation Board, except in emergency situations.

In the event of minor injuries, the employer can pay for the first aid treatment directly.

An injury is considered minor if:

  • It requires two treatments or less
  • Downtime at work is less than a day

In the case of minor injuries, the employer created an injury report but did not send it to the New York State Workers Compensation Board or their insurance company. Instead, the form would remain in their business files. The employer should plan to keep these injury records for at least 18 years. The New York State Workers Compensation Board can review these files at any time.

All injuries, except minor injuries, must be reported to the New York State Workers Compensation Board and the company’s insurance carrier within 10 days. Failure to submit the filing within 10 days means the New York State Workers Compensation Board could impose a fine of up to $ 2,500.

Compensation costs for New York workers

Several factors influence the cost of compensation in New York, including the company’s payroll, location, number of employees, claims history, and the type of industry.

The estimated employer compensation for workers’ compensation in New York, according to Cerity, is $ 0.07 per $ 100 payroll for the lowest risk jobs and $ 29.93 per $ 100 payroll for the highest risk jobs.

Avoiding an Employee Comp Claim

Most employee compensation claims are recognized and benefits are indisputably paid. If a claim is contested, it is the responsibility of the New York State Workers Compensation Board to resolve it.

In addition, complex disputes may require a formal hearing in front of a compensation judge. Most of these hearings result in a written decision from the judge.

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