Content reviewed by:
Alex Shulman
If you have been injured in the workplace and are collecting or have filed a claim for workers’ compensation benefits, you may wonder about using PTO while on workers’ comp. In many circumstances, you may have the legal right to use any accrued PTO benefits as a source of income if you are not receiving monetary benefits through workers’ comp.
If you are out of work for a week or more due to a workplace injury, you are entitled to lost wage or wage replacement benefits, which equal a percentage of your average weekly income. Your employer cannot force you to use your sick pay instead of workers’ compensation wage replacement benefits. However, if you are not receiving indemnity benefits from workers’ compensation, using PTO may be available as a way to avoid loss of income.
If you have questions about this process, contact Shulman & Hill to speak with a workers’ comp attorney in New York City and learn more about your options as an injured employee.
Replacing Wage Income With PTO During Workers’ Compensation
Workers’ comp wage replacement benefits generally only entitle injured employees to a percentage of their average weekly income. The reduction of income following a workplace injury places a major financial burden on your family to add to the stress of dealing with an injury. Using accrued PTO to continue receiving your salary can be helpful in this difficult situation, enabling you to maintain the standard of living you’re used to after your injury. You may have the option to use your accrued time, rather than claiming indemnity benefits for your lost time through workers’ compensation.
If this is desired, or if the workers’ compensation insurance carrier is not paying your lost time benefits, you may be able to start using available PTO immediately after suffering a work injury, even before receiving workers’ compensation benefits. The filing process for workers’ compensation claims can be lengthy, and there is no guarantee that your claim will be approved. Using PTO before your claim is approved ensures you’ll get paid for the time you’re out of work and waiting for your workers’ compensation benefits.
Using PTO When Workers’ Compensation Claims Are Denied
Unfortunately, insurers often deny workers’ compensation claims when injured employees initially apply for benefits. Claims may be rejected for a variety of reasons. These include failing to inform your employer of your injury in a timely manner, missing the deadline for filing a claim with the Workers’ Compensation Board, not obtaining medical treatment from an authorized provider, and having your employer dispute your claim.
When treating you for a work-related injury, your doctor will generate a medical report and submit it to the New York State Workers’ Compensation Board as part of your claim. During the claims process, your employer’s workers’ compensation insurer may ask you to undergo an independent medical examination, or IME, conducted by a separate consultant chosen by the insurer. The insurer uses the IME to procure an opinion as to what your injuries are, whether those injuries resulted from a workplace accident, and how disabling they are Insurers may use IMEs to refute your claim or reduce the benefits they pay.
If your employer’s insurer denies your workers’ comp claim, you can request a hearing before a New York Workers’ Compensation Board judge. If the judge disallows the claim, you can appeal the decision. You must submit an application for appeal to the Workers’ Compensation Board within 30 days of the decision containing the judge’s denial. An experienced workers’ comp attorney in your area can help you understand more about the appeal process, claim denials, and contingency fee arrangements.
How To Use PTO Before Workers’ Compensation Kicks In
Using PTO before receiving approval of your workers’ compensation benefits can be a good idea when possible, as it can bridge the gap of otherwise unpaid time while you’re out of work. Guidelines for using sick pay or PTO also vary from workplace to workplace. The PTO and sick time you can take depend on your employer’s internal policies and the regulations set by its insurer.
When you return to work, it’s possible in some cases to make a claim for the restoration of some of the PTO benefits you used before receiving workers’ comp, meaning that you would regain some of the PTO you spent in place of your workers’ comp benefits. If this is a path you want to pursue, consider the pros and cons of restarting your PTO accrual, especially if you have used all of your available PTO while waiting for workers’ comp benefits to kick in.
After being injured in an accident at work, consult an attorney to discuss your company’s policies around PTO and determine the best option for your situation.
What To Do if Your Employer Violates Workers’ Compensation Laws
If your employer violates New York’s workers’ compensation laws, you can file a complaint with the New York State Workers’ Compensation Board. Employers may face penalties for unjustifiably delaying payments, improperly terminating benefits, retaliating against an employee for filing a claim, or denying a claim without proper investigation.
It’s also illegal for your employer to discriminate against you based on your immigration status when paying out workers’ comp benefits. Workers who are undocumented or otherwise don’t hold United States citizenship are entitled to equal workers’ compensation in the state of New York. If your employer threatens, harasses, fires, or otherwise discriminates against you for your immigration status after filing a workers’ comp claim, it can face legal penalties and fines.
If you’re concerned about whether your employer has violated any workers’ compensation laws, contact the dedicated attorneys at Shulman & Hill. We can answer all your questions and protect your rights as an employee.
Rely on Shulman & Hill for Your Workers’ Compensation Questions
If you have questions about your rights to use PTO while claiming workers’ comp benefits, or other issues following a work injury, rely on Shulman & Hill for help. We’re a community-centered, community service law firm with a decade of experience serving all of New York City, with offices in Manhattan, Brooklyn, Queens, the Bronx, Long Island, and Staten Island. No case is too complex or challenging for our diligent workers’ comp and personal injury attorneys.
Call us today at (212) 221-1000 or contact us online to schedule a free consultation. We are available 24/7. Hablamos español.
