The claim begins by the injured worker filing a C-3 form. The injured worker is called the claimant. The Workers’ Compensation Board then checks its computer to see if the employer has an insurance company or is self-insured. (If the employer did not have insurance and is not self-insured, then the case will ultimately be the responsibility of the Uninsured Employer’s Fund). The Workers’ Compensation Board assigns an eight-digit number to the claim, called the WCB number. The Workers’ Compensation Board sends the insurance company or the self-insured employer a notice that the claim has been filed (form EC-84). The insurance company or self-insured employer must either inform the claimant that is accepting responsibility for the claim (form C-669) or inform the claimant that it is controverting (fighting) the claim (form C-7). The insurance company or self-insured employer must file its form within twenty-five days from the date the Workers’ Compensation Board’s notice was mailed. Once the C-7 form is filed, the Workers’ Compensation Board schedules a hearing. At the first Hearing the Law Judge rules on whether the claimant has produced prima facie medical evidence. Is he/she has, the Law Judge then directs the carrier or self-insured employer to have the claimant examined by its own doctor (unless this has been completed already). The Law Judge may also schedule another hearing where the claimant will testify about her employment, her work activities, and her notice to his/her employer of the injury, etc. The other side may produce witnesses as well.
If the insurance company or self-insured employer agrees that the claimant has suffered an occupational disease that is causally related to his/her work, then the Law Judge will likely establish that the case is compensable to the next hearing. If the opposing doctor denies the disease is related to the work, then the Law Judge will direct testimony of the doctors so that the Law Judge can decide which doctor is more credible. The Legal Representative for the other side cross-examines the claimant’s doctor, and the claimant’s Legal Representative cross-examines the insurance company or self-insured’s doctor. If the claimant wins, the other side often will appeal the decision to a panel of Commissioners of the Workers’ Compensation Board; if the employer wins, the claimant will often appeal. In a small minority of cases, the party that losses at the Workers’ Compensation Board level may appeal to an appellate court.
Every case is different. Many other issues will arise in the case even after the claim is established as compensable, especially issues relating to treatment and disability.
If you choose to accept Workers’ Compensation Benefits you can not sue your employer.
However . . . If you are involved in a motor vehicle accident with another car you might be able to file a lawsuit with the driver of the other car.
We frequently represent Workers' Compensation cases in Long Island New York (NY) including, Albertson, Bethpage, Dix Hills, Elmwood,Huntington, Huntington Station, Levittown, Westbury, South Huntington, Hicksville, Bayville, Glenncove, Merrick, Bellmore, Syossett, Jericho, Plainview, Roslyn, Roslyn Heights, Deer Park, Glenn Head, New Hyde Park, Manhasset, Farmingdale, Hauppague, Patchague, Deer Park, east Meadow, Mellville. In Queens we often help people in Flushing, Jamaica, Douglaston, Long Island City