New York Workers Compensation pays you for the lost wages and medical care resulting from an injury or illness that happens on the job.
And most workers comp claims in New York end with a settlement, with the injured party and the insurance company agreeing to a lump sum or schedule of payments.
In this video I’m going to explain the different types of settlements available to you, and the step-by-step process of settling your claim.
And stay tuned to the end for tips on how you can maximize the total settlement you receive.
My name is Rex Zachofsky and I became a New York workers compensation lawyer 17 years ago after getting injured on the job. If you’re looking for a lawyer to help you with your claim with New York Workers Compensation Benefits, please give me a call at 212-406-8989 to schedule a free consultation.
In New York there are generally two types of workers compensation settlements: Stipulated agreements and Section 32 waiver agreements. Like all monetary awards, both of these settlements are tax free.
A Stipulation is an agreement. Generally, the parties can agree to just about anything.
In the context of a settlement, stipulated agreements are when you and the insurance company agree on the extent of your disability and the amount of money you’ll receive.
These can also be used to settle both Schedule Loss of Uses cases as well as permanent partial disability cases, but are more commonly used in settling the schedule loss of use of an injured extremity.
For more information about the different types of permanent injury please check out my other video.
Cases that have been closed with stipulated agreements may, under certain circumstances, be reopened if your condition worsens. You can request that the New York Workers’ Compensation Board reopen your claim if additional treatment becomes necessary and to reevaluate your permanent disability or impairment.
A Section 32 wavier agreement, on the other hand, ends your right to ongoing benefits in exchange for a lump sum payment. It’s called a “waiver” because you are essentially “waiving” your right to request additional benefits in the future.
These types of settlements are commonly full and final closures of a particular claim. This settlement puts an end to ongoing monetary awards, as well as medical benefits. However in certain circumstances, the parties may enter into what is known as an “indemnity only section 32 agreement”.
Under this type of agreement the parties settle the monetary portion of the claim with a lump sum settlement, while the insurance company remains liable for payment of ongoing medical care for the injuries and disabilities related to the claim.
Once your case is settled with a full and final Sec 32 agreement however, it is closed forever and cannot be reopened, even if you run out of money for medical treatment or your condition unexpectedly worsens.
Despite that fact, Section 32 agreements are generally considered the settlement of choice, often because the insurance company wants to end its legal responsibilities and the injured person wants to move on with their life with cash in hand.
If you go this route, just make sure you receive a substantial cash settlement that makes it worth giving up the benefits you’re entitled to. I’ll discuss how to maximize your settlement in just a moment.
So how does the New York Workers Comp settlement process work?
There are two elements in any claim, and you can settle one or both of them with the insurance company: Your compensation for lost wages, and the medical care related to any treatment or disability.
Note that if you do decide to settle your medical care coverage through a section 32 waiver, you might need to set up a “Medicare set aside account” to pay for future medical treatment according to the rules and regulations provided by Medicare.
Failure to do so could result in Medicare refusing to pay for ongoing treatment if those funds are exhausted, and your out-of-pocket health insurance will not cover the cost of care.
Even in circumstances where a formal Medicare set aside is not required, it is very important that you consider the cost of any future medical care you may need.
I’ll include a link to more information in the description below.
The settlement process starts with you or your lawyer approaching the insurance company, or vice versa. Oftentimes, the insurance company will make a low initial offer that does not adequately consider the value of your claim. This is simply their attempt to get a quick easy cheap settlement of an otherwise valuable case.
Do not be discouraged by a low initial offer. And certainly do not be angry at your lawyer for bringing you this low offer. As your attorney, we are obligated to bring you any offer the insurance company makes. You will continue to negotiate terms of the settlement that both you and the insurance company can agree to, at which point either the insurance company or your lawyer will draw up the agreement.
The agreement is then submitted to the New York State Workers' Compensation Board to review and set for a settlement hearing in front of a law judge.
Once your settlement has been approved by a law judge the parties will enter into a 10 day cooling off period, during which time either party to the settlement may change their mind and back out. If anybody chooses to withdraw from the settlement during this period, you must do so in writing and that must be received by the board and insurance company within the 10 day period.
Your section 32 is not final and binding until it has been approved by a judge and the waiting period has passed. Once the ten day period has passed, the Workers Compensation Board will file a Section 32 notice of approval.
Once this notice of approval has been filed, the insurance company has ten days from the filing date to pay your award, and at that point, the settlement process is complete.
How do you maximize the amount of compensation you receive in your workers comp settlement?
As we just discussed, the insurance company has a team of lawyers trained to minimize the amount of money they pay you. At the end of the day they are a business trying to maximize their profits like any other, and they don’t care about people filing a claim.
It sounds harsh to say, but to them you are just numbers on a page.
So what are some steps you can take to ensure you receive the compensation you’re entitled to?
Number one: file your claim as early as possible.The longer you wait, the more difficult it is to get the maximum settlement possible.
Second, keep records of everything. Most importantly keep track of all of your out-of-pocket medical and travel expenses related to your claim. You are entitled to be reimbursed for all of your medical and travel expenses.
Third, don’t give the insurance company to get a recorded statement from you, even if it’s over the phone. If an insurance company is trying to get more information than you already provided when you filed your claim you should really get the advice of an attorney.
It’s not uncommon for them to try to use your answers against you and ultimately lower the value of your settlement.
Next, be open and honest with your treating doctors as well as the insurance company’s consulting physicians. Let them know exactly what you injured in the accident, even if you feel like those injuries have gotten better! It is still important to note what body part to hurt when you first had your accident or disability.
Also if you are experiencing new or different pain or discomfort as time goes on it is important to let your doctor know. Properly documented medical records are of the utmost importance in pursuing a Worker’s Compensation claim.
But the most important step you can take to ensure you get the maximum settlement possible is to get the help of a workers comp lawyer who understands how to go to bat against the insurance companies. This can more than double the amount of compensation you ultimately receive compared to going it alone.
So if you or a loved one have been injured on the job here in New York and would like to set up a free consultation, give me a call at 212-406-8989 today, and together we can get you the settlement you deserve.
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🔹 Learn more about Stipulation and Section 32 Waiver Agreements here: http://www.wcb.ny.gov/content/main/agreements.jsp