How to File a Workers’ Comp Claim in Queens

Basic Steps to File a Workers’ Compensation Claim

In any workers’ compensation claim in New York, there are five things that must happen:

1. Qualify for workers’ comp: Not all workers are eligible for workers’ compensation coverage. Specifically, you need to be a qualifying employee, not an independent contractor in most cases. Also, you have to be hurt while completing a job-related duty.
2. Report your injury to your employer: You need to inform your employer that you were injured at work or while completing a job-related duty. Your report should be given within the hour or the same day at the latest. Legally, you must inform your employer within 30 days, or your right to get workers’ compensation can be removed.
3. Gather information about your accident and injury: Workers’ compensation is a no-fault system, but that does not mean that evidence is not useful. Gather information about our accident, how and why it happened, and what injuries it caused you to suffer. When you file your claim, this information will help you back your statements in case there is any doubt.
4. Complete a C-3 employee claim form: In New York, workers’ compensation insurance claims begin with a C-3 employee claim form. You can retrieve this form offline from the New York Workers’ Compensation Board, or you should be able to get one from your employer. Either way, it should be free. Fill it out as much as possible.
5. Submit it to your employer: The last step is to submit the completed form to your employer, so they can use it to forward the claim to their workers’ compensation insurance provider.

At any point in this process, if you feel confused or worried, then you should pause and get a workers’ compensation attorney on your side. We would be happy to explain your rights and options in full detail, so you can feel confident about your future again.

What Happens If My Workers' Comp Claim Is Denied?

If your workers' compensation claim is denied in New York, it can be frustrating and stressful. However, you have the right to challenge the denial and seek a reconsideration or appeal.

Here are the steps to take if your workers' compensation claim is denied:

• Review the Denial Notice: Carefully read the denial notice from the New York State Workers' Compensation Board. This notice should specify the reasons for the denial.
• Contact Your Employer: Discuss the denial with your employer and their workers' compensation insurance carrier. Sometimes, the denial may be due to administrative errors that can be corrected without the need for formal appeals.
• Request a Hearing: If you believe the denial is unjust, you have the right to request a hearing before a workers' compensation law judge. This request is made by completing a C-3 form (Employee Claim) and submitting it to the Workers' Compensation Board.
• Gather Evidence: To support your case at the hearing, collect all relevant medical records, witness statements, and other documents related to your injury or illness. This evidence will help establish the work-related nature of your condition and the need for compensation.
• Attend the Hearing: Attend the scheduled hearing and present your case. The judge will consider the evidence and make a decision.
• Request a Review by the Workers' Compensation Board: If you disagree with the judge's decision, you can request a review by the Workers' Compensation Board's Appeal Board. This request is made using a C-108 form (Application for Board Review). You typically have 30 days to request this review.
• Consider Further Legal Action: If the Board's Appeal Board upholds the denial, you may still have legal recourse. You can consult with an attorney and consider filing a formal lawsuit in a New York state court. This is a more complex and time-consuming step, but it is an option for challenging a denial.
• Keep Records: Throughout the process, maintain copies of all documents, correspondence, and records related to your workers' compensation claim. These documents may be important if you need to prove your case during appeals or legal proceedings.
• Be Timely: It's crucial to adhere to all deadlines and timelines associated with the appeals process. Failing to meet these deadlines can jeopardize your ability to challenge the denial.
• Seek Legal Advice: Consult with an experienced workers' compensation attorney. An attorney can guide you through the process, help you build a strong case, and represent your interests at hearings and during the appeal.