Workers' Comp Q&A!!! (April 2025)

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Workers Comp Q&A!!! (April 2025)

From figuring out who’s actually calling the shots in your case to what it means if your employer shuts down, this Q&A hits on a lot of important stuff. You'll find multiple practical tips to help you better understand your rights and make smart moves as your case moves forward. Let’s jump in.

What if a Judge Sets a Dollar Amount on my Case—is That Final?

Sort of, but not completely.

If a judge in your New York workers' comp case decides how much money you should get—or gives you a disability rating—that decision is basically final for now. It becomes the official ruling everyone has to follow… unless it gets appealed.

But here’s the deal: just because you—or the insurance company—don’t like what the judge said doesn’t mean you can snap your fingers and undo it. To win an appeal, someone has to prove the judge made a real mistake—like getting the facts wrong or applying the law the wrong way. And that’s not exactly easy.

Here’s how the appeal process works:

  • First, it goes to a panel of three commissioners at the Workers’ Compensation Board.
  • If one of those commissioners disagrees with the others, then it can go to the full board for review.
  • After that, it might even go to state court—but that’s a bigger, more complicated step.

So, is it truly final? Not 100%. But unless someone files a solid appeal and wins, the judge’s decision stands—and it’s treated as the law of your case in the meantime.

What Happens When the Insurance Company Appeals?

Let’s say the judge rules in your favor—maybe gives you a 50% disability rating—and the insurance company files an appeal. What now?

They’re allowed to do that. Appeals are part of the process, even if it feels like they’re just stalling. But here’s the catch: while the appeal’s pending, they don’t have to pay you everything the judge awarded.

  • If they’re only disputing part of the decision—like they think it should be 25% instead of 50%—they’ll usually pay the 25% and hold back the rest.
  • If they’re appealing the whole thing, they might not pay anything until there’s a ruling on the appeal.

The upside? If the judge sided with you and you didn’t appeal, you’re in a stronger position. The ball’s in their court now, and that can give you some leverage—especially if you’re looking to negotiate a settlement.

What If my Company Goes Out of Business?

Good news—you’re still covered.

In New York, what matters is when you got hurt. If the injury happened while the company was still up and running and they had valid insurance, then their insurance carrier is still on the hook—doesn’t matter if the business closed the next day.

Now, if the company didn’t have insurance at the time? That’s tougher, but not the end of the road.

In that case, the Workers’ Compensation Board can step in. You’d file a claim, and if it’s legit, the Uninsured Employers Fund may take over and pay your benefits. The state might go after your old employer later to get that money back, but that’s not something you need to stress about. Your focus can stay on getting the care and compensation you need.

Do Side Jobs That Pay Cash Count as Concurrent Employment?

Yep—if the side job qualifies.

Say you make $600 a week at your main job and another $600 at your side job. If you were working both jobs around the time of the injury, and you can prove it, your weekly wage could be calculated as $1,200 instead of just $600. That means bigger benefits.

But there’s a catch: that second job has to be covered under New York’s workers’ comp system. Not every type of job qualifies—federal jobs like USPS, for example, follow a different system.

Also, if the second job pays you in cash, it’s not impossible to use it—but you’ll need proof. Things like Zelle or Venmo records, pay texts, handwritten envelopes with amounts, or even a letter from your boss can help show you were really working and what you were earning.

How Long Does my Employer Have to Hold my Job While I’m Out on WC?

Here’s the truth—at least in New York—they don’t have to.

Yeah, that sounds rough, but here’s the deal: there’s nothing in the workers’ comp law that says your employer has to hold your spot forever. The system’s set up to help you heal and get some income while you’re out, but it also understands that businesses still need to function. If you’re out for a while and they need someone to do your job, they can usually bring someone else in.

Now—they can’t fire you just because you filed a comp claim. That’s called retaliation, and it’s 100% illegal.

Also, depending on your situation, you might have some job protection through federal laws like FMLA (Family and Medical Leave Act), which can give you up to 12 weeks of job security. But that’s a whole separate system, and not everyone qualifies for it.

Can I Apply For Paid Leave While I'm Getting Paid From WC?

The short answer is yes, but there’s a big catch—you’ve got to be totally honest about your situation.

People often ask if they can also apply for things like:

  • Paid family or medical leave
  • Social Security Disability (SSDI)
  • Unemployment
  • State disability
  • Public help like SNAP or food stamps

You can look into these, especially if your comp checks are slow or don’t cover everything. But each program has its own rules, and what you say on one application can affect the others.

Is it a Good Idea to Have the Same Lawyer for WC and my 3rd Party Settlement?

Maybe. What really matters is that your lawyers—whether it’s one or two—are working together.

Some firms handle both types of cases in-house, but more often, they’re split up. That’s totally fine, as long as your comp lawyer and your third-party lawyer are on the same page and talking to each other.

Why does it matter? Because what happens in one case can affect the other. For example, if you settle your third-party case, your comp insurance might want some of that money back—they may have a lien on it. That kind of stuff needs to be coordinated.

Is Getting a Second Opinion About my Case Legal?

Yes, you’re totally allowed to get a second opinion, just like you would with a doctor.

That said, there are a few things to keep in mind.

It’s usually easier to get another lawyer’s take early on or midway through your case. If you’re already deep into it and just want someone to weigh in on a possible settlement, it can be tough. They’d need time to look through everything, figure out what’s already been done, and decide if they’d even handle it differently.

Can I End my Case Whenever I Want and Still Settle?

In New York, workers’ comp settlements are voluntary. That means neither you nor the insurance company can be forced into a deal. You both have to agree.

So when’s the right time to settle? That depends on a few things:

  • Have you hit Maximum Medical Improvement (MMI)—meaning you're about as healed as you’re going to get?
  • Are you still in treatment or thinking about having surgery?
  • Did the insurance company appeal a decision that went in your favor?

These factors all matter. And here's the big one: once you settle, that’s it. A Section 32 settlement is final. You’re closing the case, usually for a lump sum, and giving up the right to come back later for more.

What if I Get a Lowball Offer and Don't Accept it?

If the insurance company throws you a lowball offer, you’re not stuck with it—you don’t have to take anything you’re not comfortable with. Just because they made an offer doesn’t mean the case ends there.

If you say no, a few things can happen:

  • They might come back with a better offer, especially if they know you’re willing to hold your ground.
  • Your lawyer can try to negotiate and push for something more reasonable.
  • If no agreement is reached, your case can keep moving forward through the regular process—hearings, medical updates, maybe even trial, if needed.

What if the Section 32 Gets Kicked Back Asking For More Information?

This happens more than you’d think. If you filed for a Section 32 settlement and the Workers’ Compensation Board sends it back asking for more info, don’t panic—it usually just means something small got missed.

Sometimes it's as simple as:

  • A missing signature
  • A form that wasn’t attached
  • A typo in the numbers (even being off by a penny can trigger a delay)
  • Or forgetting to mention something like an outstanding medical bill or a carrier’s objection (like a CA-1.0 form)

In most cases, your lawyer or the insurance company can fix it pretty quickly. Sometimes the Board flags something that’s actually already been handled, and it’s just a matter of clearing it up.

What if I Get Into a Car Accident While I’m Already on WC?

If you’re already on workers’ comp and then get into a car accident—yes, you should tell your lawyer and your doctor. It might not affect your comp case, but it also might, depending on what got injured and how.

Your doctor needs to know because it could change your treatment plan or impact your recovery. And your lawyer definitely needs to know so they can protect your case and advise you on what to do next—especially if there’s overlap between the injuries from your work accident and the new ones from the car crash.

What if my Salary is Higher Now Than it Was Before my Injury—Can That Affect my Section 32 Settlement?

Yes, it definitely can have an impact—especially if your case involves lost wages or reduced earnings.

Here’s the deal: if you’ve gone back to work and you’re making more now than you were before you got hurt, the insurance company may argue that you haven’t lost any earning capacity. And if you’re not losing money, that can reduce the value of your claim when it comes time to settle—especially in a Section 32.

Why? Because a big part of many settlements is based on how much the injury has affected your ability to earn. If you’re earning more now, they might say, “You’re doing fine, so we don’t owe as much going forward.”

Is it Possible to File WC For Work-Related Depression?

Absolutely—workers’ comp isn’t just for physical injuries. Mental health stuff like anxiety, depression, or work-related trauma can count too, if it’s directly tied to your job.

That said, these cases aren’t always easy. You’ll need a few things to back it up:

  • A legit diagnosis from a licensed therapist or psychiatrist
  • Proof that your mental health issues are connected to something that happened at work
  • Consistent treatment records showing this isn’t just a one-off bad day

The insurance companies usually push back hard on these, so documentation really matters.

How Long Does it Take For a Judge to Determine Temporary Total Disability (TDD)?

Once everything’s been submitted—like medical records, hearing transcripts, and closing arguments—it usually takes a few weeks for the judge to make a decision. Sometimes it’s faster, sometimes slower, depending on how backed up the system is.

If a hearing already happened and the judge “reserved decision,” that means they’re reviewing everything before making a call. You might be waiting a bit, but it’s totally normal. Your lawyer should keep you in the loop if there are any updates or if the judge needs anything else before deciding.

Contact Us For Help With Your Workers' Compensation Case

If you’ve got questions about your own case, or you're just not sure where to go next, feel free to reach out. Give me, Rex Zachofsky, a call at 212-406-8989. Whether you’re just starting out, stuck in the middle, or dealing with an appeal, let’s see if we can make it a little easier on you.

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address

111 John Street
Suite 1615
New York, NY 10038

phone number

212-406-8989