Workers' Compensation Medical Treatment Limits

New York Workers' Compensation Guidelines

If you have suffered a serious injury or illness that will keep you from working, you are probably wondering: What are the limits to the medical treatment I can receive from Workers' Compensation? Like most aspects of the law, the answer to this question changes frequently, and in this case, the answer is less beneficial to injured workers in New York than it used to be.

Fortunately, our attorneys and staff have dedicated our entire legal practice to helping injured workers in New York. Our Schenectady Workers' Compensation lawyers have decades of experience with changing Workers' Compensation law, so we are well-positioned to help you navigate this complicated system and obtain the benefits you need.

At Silverman, Silverman & Seligman, P.C., we have been successful with thousands of Workers' Compensation claims, and we never forget that our clients are the most important aspect of what we do. We will treat you with the respect you deserve as we fight for the compensation you need.

Permission for Medical Treatment

In December 2010, injured New York workers' access to medical care changed dramatically under Workers' Compensation law. Before that time, a doctor needed permission from the insurance carrier to provide any treatment worth more than $1,000. This requirement was removed in December, resulting in one of the most significant changes to Workers' Compensation since its inception.

Although this change to the Workers' Compensation medical treatment limits would seem to provide greater access to medical care for injured New Yorkers, it actually has had the opposite effect. The new guidelines set out a process by which a doctor can provide treatment worth more than $1,000. If the doctor follows the process, he or she does not need authorization. Doctors are dealing with the system under the fear that they will be held liable for possible missteps in the procedures. These complicated procedures include incredibly strict guidelines that ultimately make access to medical procedures like fusion surgery even more challenging for injured workers in New York. The new guidelines also limit the extent of physical therapy or treatment that injured workers can receive.

If you are in need of medical care worth more than $1,000, it is important, under the new guidelines, to work with an experienced legal team. Our attorneys can help you through the legal process and explore other means of financial compensation for your injuries.

Contact Capital District Workers' Compensation Lawyers ∙ Free Initial Consultations

We serve clients in all upstate Capital District counties. If you have experienced a work-related injury, you can talk with one of our experienced lawyers. Call 518-631-4521 or contact us online for a free initial consultation with a New York work injury compensation attorney.

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• What do I need to show to obtain Workers Compensation benefits?

  
  In order to obtain compensation benefits you need to document that you were an employee, that an accident occurred during the course of your employment (or you developed an "occupational disease" during the course of your employment), that you gave notice to your employer within 30 days of the accident and that you filed your claim for benefits within two years of the date of the accident. There are some exceptions to these requirements which should be discussed with your attorney in detail.

• If the administrative law judge directs the carrier to pay my medical bills and to pay me compensation benefits, and the carriers still objects, what happens?

  
  If a carrier believes that there are grounds for an appeal they may file such an appeal within 30 days to the Workers Compensation board. Pending the resolution of that appeal in most instances the carrier is not required to pay medical bills or make biweekly payments to the Claimant as directed by the administrative law judge.

• Am I required by law to have an attorney?

  
  No. But bear in mind that the insurance carrier is mandated by law to have an attorney or a licensed representative appear at every hearing. These attorneys and licensed representatives often have years of experience, have handled thousands of hearings and are well versed in representing the carrier's point of view. While there is no similar statute requiring the Claimant to be represented, we would highly recommend that they retain counsel. Silverman Law has decades of experience in representing Claimants.

• The carrier argues that my condition was pre-existing. I don't think that it was but even so I never had these symptoms. What should I do?

  
  This question of a pre-existing asymptomatic (unnoticed) condition which is made symptomatic by a work-related accident has been decided by both the Appellate Division of the Supreme Court of New York State and the New York State Court of Appeals.

• Can I collect both Workers Compensation and the Social Security Disability benefits at the same time?

  
  Yes. If you qualify you may indeed collect both Workers Compensation and Social Security Disability benefits. While Workers Compensation is not reduced because of Social Security Disability payments, your Social Security Disability payments may indeed be reduced because of your Workers Compensation benefits.

Silverman, Silverman & Seligman, P.C.
527 State St.
Schenectady NY 12305
Phone: 518-631-4521
Toll Free: 877-851-4319
Fax: 518-374-4338