We continue this week on our Syracuse workers' compensation law blog with our response to a frequently asked question. That is, what happens when an injured worker files a claim for benefits? Last week we walked our readers up through the point at which payments may begin. There are, however, some key dates and time frames to keep in mind even past that point.
An important consideration is whether there is a dispute surrounding the worker's compensation claim. If there is, the insurer has 18 days from receipt of the injury notice form to appraise the state Board of that fact. All parties to the claim (not just the Board) must be notified if payment is being withheld for some reason indicated on the form.
Assuming that there is no dispute -- or once a dispute is resolved -- payments will issue every two weeks to the injured worker. Should biweekly payments become subject to modification or termination, the insurance carrier must alert the Board. Otherwise, a physician must provide reports on the progress of rehabilitation to the Board every 45 days, and after 12 weeks the insurer will take a look at the need for such treatment under current circumstances.
As these milestones demonstrate, there are a lot of moving parts involved in a workers' compensation claim. Many disparate parties have steps to complete in a timely manner. Unfortunately, if another party fails to meet a particular deadline, it should be all too obvious whose benefits are at risk.
This information is general in nature only and should not be interpreted as specific legal advice. We do, however, emphasize that legal representation from an experienced professional can help injured workers whose benefits who depend on their benefits when questions come up, forms are filled out incorrectly or deadlines missed.
Source: New York State Workers' Compensation Board, "Understanding the Claims Process," accessed on March 13, 2015