Injured workers call us with a version of the same sentence: nothing is happening on my case. No hearing, no decision, no money, no answer. They assume the insurance company is behind it, and sometimes it is.
Often it is not. Often the claim is stalled because a piece...
Your surgeon says you need the operation. The carrier says no. You are sitting at home with a torn shoulder and a denial letter, and the honest question in your head is whether this is the end of it.
It is not. A denial in a New York workers’...
A schedule loss of use award is one of the few things in a New York workers’ compensation case that is pure arithmetic. Three numbers decide it: the body part, the percentage of function you permanently lost, and what you were earning before the accident. Everything else is argument about those three...
You are out of work. Your doctor has you out. The claim has not been denied. And no money is coming. You call the adjuster and get voicemail, or you get a person who says it is being reviewed. Weeks go by. Rent does not wait for the carrier’s review.
A letter arrives, addressed to your attorney or to you. A company you have never heard of says it has been retained by your employer to provide “telephonic case management,” that a registered nurse has been assigned to your file, and that the nurse would like your permission to call you and...
You tore a rotator cuff and hurt your back in the same accident. The shoulder was repaired and it is never going to be what it was. The back is a permanent problem too. At permanency, somebody tells you that because your back is involved, there is no schedule award for the...
The pattern is always about the same. You got hurt at work. The checks came for a while, then stopped. Maybe you went back on the job, maybe you just stopped going to the doctor because the appointments were not fixing anything. The case went quiet. Nobody called. You assumed that was...
You get hurt on the job. You call the hall, or the shop steward comes over, and you are given a name. Sometimes it is a card, sometimes a phone number, sometimes a firm that has been handling members' cases for twenty years. You call, somebody comes to the house, and you...
If you have only ever dealt with regular health insurance, the workers' compensation system will feel backwards. Under a health plan, the default is that nothing is covered until somebody approves it. In New York workers' compensation, the default is the opposite: most of the treatment you need is already authorized by...
There is a rule at the Workers' Compensation Board that almost nobody outside the practice knows about, and it is the reason an injured worker on Staten Island or in Brooklyn can open a claim, litigate it, and settle it without ever sitting in a lawyer's conference room. The Board no longer...
