FAQ

 

Workers' Compensation

Social Security Disability

Disability Pension

 

WORKERS’ COMPENSATION

 

Q. What are the Workers’ Compensation benefits I can receive?

A. Workers’ Compensation benefits include both medical treatment for work related injuries and monetary benefits for the time you are out of work and remain disabled.

 

Q. What must I do if I am injured at work or believe my work activities have caused a condition which affects my health?

A. As soon as an incident occurs or you believe your work activities have caused some condition affecting your health, you must notify your employer within 30 days and seek medical treatment. Notification to the employer is best done in writing on an incident report.

 

Q. What must my doctor do?

A. Under the NYS Workers’ Compensation Law, the doctor is required to submit reports to the NYS Workers’ Compensation Board, and your employer’s Workers’ Compensation insurance company.

 

The doctor’s report should be prepared on an approved workers’ compensation form and describe the history of the work activities or conditions that cause the injury or disease. The report must indicate that, in the doctor’s opinion, the injury or disease was caused by the work activities or conditions. The report must also provide a diagnosis, treatment plan, and indicate the percentage of impairment resulting from the injury.

 

Q. How do I pay for treatment?

A. All treatment and prescription medication related to the work injury is paid for by the insurance carrier, including reasonable travel expenses to and from the doctor’s office. Do not pay your doctor for treatment or use your private health insurance.

 

Q. When and how do I get paid for being unable to work because of my disability?

A. Once the carrier has knowledge of your injury and has received medical reports supporting your injury and disability, the carrier is required to pay benefits under the law unless the carrier is disputing your claim. If your claim is not disputed, you may receive up to 2/3 of your average weekly wage, but no more than the statutory maximum set by law. Your benefits are non-taxable.

 

Q. Why were my monetary benefits reduced or stopped?

A. If you were examined by the insurance carrier’s doctor, it is likely that the report states that you have a partial disability or no disability.

 

When your monetary payments are reduced or stopped, you are entitled to a hearing before a Workers’ Compensation Law Judge to determine what weekly rate is proper based upon the medical evidence from your doctor and the carrier’s doctor.

 

Q. Why did the insurance company stop my treatment?

A. There are Medical Treatment Guidelines that your doctor must follow. If the treatment exceeds the amount of treatment in the Guidelines or varies from those Guidelines your doctor must file for a Variance. If the insurance company denies the request for a variance, the Workers’ Compensation Board will rule on the request.

 

Q. When can I return to work?

A. This is a medical decision between you and your doctor. Your doctor should advise you whether you have the ability to return to work.

 

Q. What happens to my case if I return to work?

A. If you return to work, even with a different employer, the law requires that you notify the insurance carrier and your attorney.

 

A Law Judge can authorize continuing treatment after you return to work to insure that you continue to be able to perform your duties.

 

If you return to work earning less than the wages at the time of your disability, you may be entitled to some continuing payments.

 

BEWARE: CRIMINAL PROSECUTION CAN RESULT FROM RECEIVING COMPENSATION WHILE WORKING IF YOU INTENTIONALLY FAIL TO NOTIFY THE INSURANCE CARRIER

 

Q. What if I need a special type of treatment or surgery?

A. Most types of treatment and surgery are pre- authorized under the Treatment Guidelines. Other types of treatments and surgeries may be authorized upon a request for authorization by your doctor. If the carrier disputes the request, the Workers’ Compensation Board can consider the request and rule on it.

 

Q. Who attends hearing at the Workers Compensation Board?

A. You should attend all hearings scheduled on your claim. The insurance carrier is generally represented by counsel and since the hearing is a judicial proceeding it is recorded by a stenographer provided by the Board.

 

Q. Should I have a Lawyer?

A. You should, at least, consult an experienced Workers’ Compensation attorney. There is no charge for a consultation.

 

The proceedings before the Law Judge may sometimes involve questions of law or fact and an attorney can assist you and your doctor in pursuing your claim.

 

Q. How do I pay for a lawyer?

A. The law prohibits an attorney from charging you directly for legal services. Any fee earned by an attorney is granted by the Law Judge at a hearing. The fee is deducted from your benefits and paid to the attorney directly by the insurance carrier.

 

Q. What other benefits am I entitled to?

A. If your injury or disease causes you to be unable to work you may be eligible for Social Security Disability and a Disability benefits Pension. Your attorney should advise you concerning the procedures and medical evidence required to apply for these additional benefits.

 

WHEN YOU KNOW YOUR RIGHTS, YOU WILL BE HELPFUL TO YOUR DOCTOR AND YOUR LAWYER IN PRESENTING YOUR CLAIM AND OBTAINING BENEFITS.



SOCIAL SECURITY DISABILITY / SUPLEMENTAL SECURITY INCOME

 

Q. Am I eligible for Social Security Disability benefits?

A. If you have worked long enough (usually 10 years) and have become disabled, you may be eligible to receive SSD. Each year, just before your birth date, Social Security sends you a statement of your history of earnings.

 

In some instances, younger workers need fewer years to qualify.

 

Q. What or how is the disability I have determined?

A. The general rule is that the medical reports submitted by your treating doctors must demonstrate that you are unable to perform gainful employment and the disability is expected to last for more than 1 year or result in death.

 

Medical reports may indicate all physical and mental conditions which contribute to your disability not just a work related injury.

 

Q. What other benefits are available?

A. In many cases, Social Security pays additional monthly amounts for each child under the age of 18 years. Two years after you are found eligible for benefits by the Social Security Administration, you will be enrolled in Medicare.

 

Q. When should I file for SSD?

A. Since the process may take more than a year, the sooner you apply the sooner you may receive your benefits.

 

By filing as early as possible, for example by the 9th month of your disability, you will have an opportunity to insure that the proper medical reports are submitted.

 

Q. How do I apply?

A. You can apply by calling SSA at 800-772-1213 or by visiting your local SSA office.

 

Q. I applied but was denied. What should I do?

A. Appeal the denial in writing as instructed in the letter of denial. You must do so within the deadline indicated in the denial letter.

 

You have the right to request a hearing before an Administrative Law Judge and this must be requested within 60 days of the denial letter.

 

Q. Can I appeal or appear at a hearing without a lawyer?

A. Yes. However, statistics show that the assistance of an experienced SSD lawyer increases your likelihood of success.

 

Q. Can I receive SSD and Workers’ Compensation benefits at the same time?

A. Yes. However, in some cases SSD benefits may be reduced. An experienced attorney can assist you in insuring that you receive the maximum from both programs.

 

Q. How do I pay for a lawyer?

A. Social Security must approve any fee to be paid to an attorney who represents you, and the fee is deducted from your past due benefit award and paid directly to the attorney. Before retaining an attorney, a fee agreement must be completed. There is no charge for a consultation.

 

Q. Who decides whether I am disabled?

A. In order to receive Social Security Disability benefits, you must have a physical and /or a mental disability severe enough to prevent you from working, which is supported by acceptable medical findings. Initially, at the application phase, the determination is made by the responsible state agency.

 

Q. Am I entitled to any other benefits?

A. If you are covered by a pension plan or your disability is the result of a work related injury, you may also be eligible to receive your pension and/or workers’ compensation benefits. An experienced attorney can advise you on these benefits.

 

WHEN YOU KNOW YOUR RIGHTS, YOU WILL BE HELPFUL TO YOUR DOCTOR AND YOUR LAWYER IN PRESENTING YOUR CLAIM AND SECURING BENEFITS.

 

 

PENSION LAW

 

Q. If I suffer from physical or mental disability can I apply for a Pension?

A. Whether you are an employee in the private or public sector, you may be entitled to a disability pension. If you are a NYS or NYC employee, you may apply for a disability pension with the NYS or NYC Local Retirement System. If you work in the private sector and you are the member of a Union, most Union Bargaining Contracts provide for a disability pension plan. If you are not a municipal or a Union employee, your employer as part of your employment benefits may have provided you with a private disability pension plan.

 

To be entitled to a Disability Pension, you will generally need to show that your disability is permanent and prevents you from performing work activities.

 

Q. When should I apply?

A. Since there are generally strict time limitations to file an application, you should file your application as soon as possible.

 

Q. If I’m denied my disability pension what should I do?

A. Generally when your disability pension is denied, you have the right to appeal the denial. Depending on the pension plan, you may have to file an administrative appeal or file a lawsuit. Although an attorney is not required in all cases, it is recommended that you consult with an attorney experienced in Pension Law. The law offices of Rosado, Chechanover & Bayrasli has the experience to help you navigate the pension process from application to appeal.

 

SUGGESTIONS:

 

We suggest that you take the following steps when making an application for Disability Pension.

  1. If the disability is the result of an accident or incident at work report it immediately in writing to your employer.

  2. Seek medical treatment immediately and if your disability is the result of an accident at work or developed as a result of the work performed, make sure to tell your doctor.

  3. You should not discuss your claim with anyone other than your doctor or lawyer.

  4. If the disability is work related, you should file for Workers’ Compensation immediately.

  5. You should seek legal assistance from an experienced attorney.

Q. What other benefits am I entitled to?

A. if your injury or disease causes you to be unable to work you may be eligible for Social Security Disability or Workers’ Compensation. Your attorney should advise you concerning the procedures and medical evidence required to apply for these additional benefits.

 

WHEN YOU KNOW YOUR RIGHTS, YOU WILL BE HELPFUL TO YOUR DOCTOR AND YOUR LAWYER IN PRESENTING YOUR CLAIM AND SECURING BENEFITS.