Workers’ compensation is a valuable resource for employees injured on the job. This no-fault insurance program is meant to provide income and other benefits until you recover enough to return to work. Employers are responsible for paying workers’ comp premiums, and the law prohibits them from deducting premiums from employee pay.
New York employees injured at work are entitled to workers’ compensation without paying it back. Generally, you are only required to repay benefits if you received more than you were entitled to.
When Workers’ Compensation Might Be Repaid
After a workplace injury, most employees in New York are entitled to workers’ compensation benefits. These benefits are available regardless of your citizenship status. However, you may be required to repay workers’ compensation if either of the following occurs:
- The Workers’ Compensation Board determines you received more benefits than you are entitled to.
- You receive an award in a third-party lawsuit that includes compensation for damages already covered by workers’ compensation.
Benefit overpayments may be reimbursed through ongoing deductions from future benefit payments.
Overpayment of Benefits
The Workers’ Compensation Board may allege that you received an overpayment if it determines that you returned to work and continued collecting benefits without informing the Board or carrier or if you are found to have committed fraud. Your employer’s insurance carrier may hire an investigator to talk to your neighbors, scan your social media, and spy on you in public. None of this is illegal. However, investigators can misinterpret evidence, leading to unfair denials, benefit reductions, and repayments. The insurance carrier may even accuse you of fraud and report you to the Office of the Inspector General for a formal investigation.
If the insurance company unfairly undermines your claim, our knowledgeable NYC workers’ compensation lawyers can help prove the extent of your injuries. We will work to restore your benefits to the level you are entitled to under the law.
Third-Party Lawsuits
If someone other than your employer contributed to your work-related injury, you may be entitled to sue the third party. Common defendants in third-party lawsuits include equipment manufacturers, negligent drivers, and property owners. If you recover compensation through a lawsuit, you may have to reimburse workers’ compensation awarded to cover overlapping damages.
Are Workers’ Compensation Payments Taxable?
Workers’ compensation benefits are exempt from income tax. This also applies to survivor benefits.
Can Workers’ Comp Stop Paying Without Notice in NY?
You are entitled to prompt notice from the insurance carrier before your workers’ compensation benefits are denied or modified. It must include the reason for the change. The most common reason for payments to stop is that you recovered sufficiently to be able to return to work. However, benefits may also stop due to non-compliance with program requirements.
If the insurance carrier is under a direction from the Judge or the Board to continue making payments to you for your lost time from work, unless you return to work they cannot reduce or suspend your payments without permission from the Board, usually via a hearing before a Judge.
Fraud Allegations
Your benefits may also stop if the Board believes you committed fraud, which could include:
- Claiming an injury occurred at work when it happened somewhere else.
- Misrepresenting the severity of your injury.
- Returning to work without informing the Board.
If the Board believes you received compensation through a factual misrepresentation, it could disqualify you from future benefits and lead to criminal prosecution. Our experienced workers’ compensation lawyers can help counter unfounded fraud allegations and ensure you receive the benefits you deserve.
Non-Compliance With Work Requirements
Benefits may also stop if you are cleared to return to work by a doctor. However, the insurance carrier’s medical consultants may clear you before you are truly ready.
This is common with “independent medical examiners” (IMEs), who may minimize your injuries. An IME’s report and medical opinion can be difficult to rebut without an experienced workers’ compensation attorney on your side.
When Does Workers’ Comp Start Paying Lost Wage Benefits?
If you cannot work for 1-14 days, you are entitled to wage replacement benefits covering time missed at work from the eighth day onward. However, if your disability period lasts longer than 14 days, you are entitled to benefits for every day you miss work, including the first 7.
Your employer’s workers’ compensation insurer must issue your first payment or file a dispute within the latter of:
- 18 days after your disability began.
- 10 days after learning about your injury.
If there is no dispute, you should receive payments every two weeks during your disability period.
Let Shulman & Hill Fight For Your Workers’ Compensation Payments
If you are asked to repay workers’ compensation benefits in New York, call (212) 221-1000 or contact us online to schedule a free consultation. With decades of experience handling workers’ compensation claims, we can answer your questions, investigate alleged overpayments, work to rebut an unfair allegation, and protect your rights.
