BE CLEAR ABOUT WHAT HAPPENED AND WHAT HURTS. Any statement you make to any medical provider about the accident and your injuries is CRITICAL. Be very careful about how you describe how you got hurt. Identify ALL body parts that hurt due to the accident. You must see a DOCTOR (and not a nurse or physician assistant). TELL THE TRUTH.
SEE YOUR DOCTOR REGULARLY. You should see a medical provider at least once every 90 days. If you do not, there is a risk that your benefits will be reduced or stopped. Do your best to keep ALL appointments with medical providers.
REMIND YOUR DOCTOR TO SPECIFY YOUR DEGREE OF DISABILITY. Remind your doctor to report your particular “degree” (severity) of your disability in each report. This is based on your physical ability to work in general, NOT whether you can perform your usual job.
DON’T SPEAK TO ANYONE WITHOUT OUR PERMISSION. Insurance company representatives sometimes show up unannounced at your home and at doctor appointments. They will call you and audiotape your conversation without telling you. Anything you say (or don’t say) can and will be used against you. DO NOT speak to anyone from the insurance company, or ANYONE ELSE (INCLUDING CO-WORKERS), without getting our permission first.
DON’T COMPLETE OR SIGN ANY DOCUMENT WITHOUT OUR PERMISSION. Insurance companies ask injured workers to sign numerous documents, including releases which allow them to get medical and other information about you. Don’t sign any document without letting us look at it first.
DON’T APPLY FOR UNEMPLOYMENT INSURANCE BENEFITS WITHOUT SPEAKING WITH US FIRST. There are times when you can collect both workers compensation [“WC”] benefits and unemployment insurance [“UI”] benefits. As a general rule, you can collect both ONLY if you are NOT totally disabled under the WC Law. The decision of whether to apply for UI benefits is a complex one and should be discussed with us first.
YOU MAY BE ELIGIBLE FOR SOCIAL SECURITY DISABILITY BENEFITS TOO. If you are unable to work due to an illness or injury for at least 12 months, you can collect Social Security Disability benefits even if you later return to work. Ask us about these benefits.
YOU AND YOUR FAMILY MAY BE ELIGIBLE FOR AFFORDABLE HEALTH INSURANCE COVERAGE. You are entitled to medical treatment for your work-related conditions at NO cost to you. We encourage you to explore whether you and your family are eligible for “affordable” health insurance coverage for medical treatment for other conditions under a federal law known as the Affordable Care Act. Residents of New York can learn more by visiting http://nystateofhealth.ny.gov
There is an open enrollment period for this type of health insurance. If you lose employer provided health insurance because, for example, you were not able to return to work due to the work illness or injury, you should be able to secure health insurance coverage in a 60 day “special enrollment period” even if the general enrollment period is over.
However, be careful about accepting continued health insurance coverage from your employer under a federal law known as COBRA. If you accept continued health insurance (including when the employer pays the COBRA cost), you might not be able to get heath insurance under the Affordable Care Act when the COBRA payments end if it is not in an open enrollment period.
KEEP TRACK OF YOUR MILEAGE AND PARKING EXPENSES. You have a right to be reimbursed for mileage, parking and related expenses you incur to get treatment for a work-related accident. Keep good records and submit ORIGINAL receipts.
KEEP ENVELOPES. In some cases, the insurance company is required to make payments or file forms within a certain amount of time. If they do not, they may owe you extra money. The only way we can prove your entitlement to penalty payments is with the postmarked envelope. Keep the form in its envelope, or make a note of what document came in the envelope.
LET YOUR UNION HELP YOU. You may be eligible for supplemental benefits through your union. Contact them and ask.
YOU HAVE TO LOOK FOR WORK IF YOU ARE LESS THAN TOTALLY DISABLED. There will be times when you are unable to work at your usual job but are not “totally disabled” within the meaning of the law. During those times, you are required to look for work, even if you believe that you will be returning to your usual job. YOUR BENEFITS CAN BE STOPPED IF YOU FAIL TO LOOK FOR WORK WHEN YOU ARE NOT TOTALLY DISABLED.
IF YOU CAN NO LONGER WORK AT YOUR USUAL JOB, REDUCED EARNINGS AND ACCES-VR CAN HELP. You are not “totally disabled” simply because you can no longer perform your usual job. If you are able to work in some capacity, you can “earn” more by working at a modest job than if you don’t work at all. If you work, you can keep you wage AND collect a portion (2/3) of the difference (up to a maximum lost income benefit) between what you earned in your usual job and what you are earning in your new job. BE SURE TO ADVISE US BEFORE YOU PERFORM ANY WORK FOR MONEY.
ACCES-VR is a part of the New York State government that can help you get the skills you need to do work in other fields. You can contact them at (585) 238-2900. Speak to us BEFORE contacting ACCES-VR.
YOU ARE BEING WATCHED. WC companies are using video surveillance more than ever before. With small video cameras, your activities around your home, and in your community, easily can be recorded. They also view social media sites such as Facebook, Twitter, Instagram and LinkedIn. DO NOT ENGAGE IN ACTIVITIES THAT VIOLATE THE RESTRICTIONS IMPOSED BY YOUR DOCTOR OR ARE OTHERWISE INCONSISTENT WITH YOUR WC CLAIM. YOU COULD BE CHARGED WITH A CRIME.
HEARINGS AT THE WC BOARD IN ROCHESTER. Please try to get to the hearing office about 15 minutes before the hearing. Be prepared to WAIT. Rarely will you appear before the Judge at the scheduled time for the hearing.
The WC Board is located in the City of Rochester at 130 West Main Street (First Floor) between Plymouth Avenue and North Washington Street.
From points west: Take Route 490 east and, near the inner loop, get off at the Plymouth Avenue exit (Exit 13). The light at the end of the exit ramp is Plymouth Avenue. Make a right. Off Plymouth Avenue, make a right onto West Main Street. The WCB office is on your right where West Main Street and North Washington Street come together. There is a parking lot behind the building that charges about $5.00 to park. AS YOU MAY BE WAITING FOR QUITE A WHILE, WE DO NOT RECOMMEND THAT YOU USE A PARKING METER.
From points east: Take Route 490 west and get off at Exit 14 (Broad Street/Plymouth Avenue). Go straight (you are on South Washington). When you reach the second traffic light (the corner of West Main and Washington), you will see the WCB ahead and on your right, on the NE corner of the intersection. There is a parking lot behind the building that charges about $5.00 to park. AS YOU MAY BE WAITING FOR QUITE A WHILE, WE DO NOT RECOMMEND THAT YOU USE A PARKING METER.