Workers' Comp - New York

Please read and reply... not familiar with legal issues

Bethany1974 — Thu, 19 Nov 2009 03:29:32 GMT

I have worked in group home settings doing personal care for people with physical and developmental disabilities since 1995. This past spring I had a new client and requested our staff getting extra training because we were having trouble transferring her out of bed. I have copies of numerous emails between myself, my manager, the house nurse and the agency physical therapist about trying to get this training over several weeks, most of which went unanswered or was met with aggravation. My request was to be shown via inservice, but no would comply. Our house has one staff on per shift, so there was no refusing and letting someone else until comfortable. Being I was the one getting this client out of bed, I was also the one who did the most asking, but the other staff said they had trouble as well. In April I got a "complex back injury" from having to do this transfer and have been out of work ever since. Now that it is over 6 months, I have also lost my job because they do not hold it any longer than that. I am still receiving treatment 2-3 times a week and cannot return to this line of work until I can lift 50+ pounds. Many people think I should sue my employer for negligence and refusing to train me. I'm so frustrated... Any thoughts? What does one expect from a case like this?

Getting SSD, disabilty pension and involuntary withdrawl

NYMike1 — Sat, 07 Nov 2009 21:16:18 GMT

I've been on WC for 4 years and have my permanancy from back and neck injuries and I was just approved by Social Security for SSD. The SSD will allow me to take a disability retirement and pension from previous employer. That will happen very shortly.

At what point can I stop looking for work or training through VESID because of my forced retirement due to a workplace injury?

Does WC need to see my SSD award letter or my retirement/pension statement? What makes it official in WC's eye's that they just won't pull my WC benefits because I withdrew from VESID or the labor market?

I remember some type of caselaw or precedent that covers involuntary withdrawl but can't remember the name or how WC deals with situations like mine.

Thanks for any help.

SElltemnts ???????? some Help Would Be Apericiated???

zrbcolor63 — Thu, 01 Oct 2009 11:34:39 GMT

I have a 7yr nyc worker's compensation open and fought hard for and WON Claim , i have been offered to Settle it the Money Part not the Medical. i also recieve my Social Security every month it not alot but it something.Now the selltemt is for 6.25 yr so my questions are as foollows

?1. do i keep recieveing my Social Security money. every month since i did not settle my medical. In other word i Will recieve my monthly check????

I live in Philadel... PaThe case is in New York State if this matters????

?2. If i do then i should i be able to ask Social Security for more money after my 6.25 are up since that what the settlement is for right????

?3. last one Would anyone leave maybe 13 yrs on the table for a large sum of money now in order to make that grow but losing the 13 f i live that long I hope you understand this one

claims

workerrights — Thu, 29 Oct 2009 01:16:29 GMT

I have a ppd of marked on my back and collect the maximum under the old rules.

I also have a claim on my foot and will be having surgery to relieve the pain. My doc said while the pain should be less my foot will remain permanently disabled due to the injury.

My question is will I receive the schedule loss award for my foot or will the ppd payment I receive for my back prevent a scheduled loss payment for my foot.

thanks

carrier changed their mind

roystr — Thu, 08 Oct 2009 12:21:39 GMT

several months ago,comp stopped paying for my meds,so we went to court to see the judge.

in the end,he told them to pay me back the money i spent out of pocket,and resume paying for medicine.AND any other meds that might come along that would apply to his condition.

i take two costly meds. say each $750 a month.

well,last week my dr upped one of them, for a total of 35$,and they filled it. however when i asked for the other one,they called it in and were told after adding up the ammounts,,the second med would put me way over and id need to wait for permission before i could get it.

yesterday my pharmacy called them to ask ifit was all settled yet,nothing was known. so this morning i have to call n call to see what the heck is going on.

i do know,if i get to filing the papers to get in frontof a judge,i wont be recinding them untill it has been heard by the judge. even if they pay me back/ fill prescription that or the following day.

heres the thing.

judge told them to cover the two mwds as they were written and any/all other meds that pertain to my condition,they must pay for them in the future.

well,if the first med was covered,and the sceond was covered,except for the small increase the dr made last week, then the total difference in my meds is about 600$, well under the1k$high point setup in 2007.(it usedto be 500$) [before carrier seeking courts help,or denying coverage]

so it seems to me,first the judge told them to cover any meds related to my comp condition down the road,second,the500$ dosent go over the 1000$ limmit,and therfor,i think they cant legaly stop me from getting my medication.

thats not counting the fact that they might be in contempt of court by ignoring the judges prior order.

any thoughts before i get on the phone and let em have it?

thank you all very much,

i hope its clear enough.

roystr

workercomp retail prescription plans

zrbcolor63 — Thu, 30 Jul 2009 22:01:19 GMT

i just recieved a letter saying that i have to use this drug - program when i get my med. i am not able or better yet allowed to use my own pharmacy innoviant any more i have to use express scripts from now on . that the name of this new thing i have to use EXPRESS SCRIPTS

??? does anyone know if this is legal do i have to use the insurance own prescription own program. i can use retail pharmacyies but i have had bad expericence with them. any help would be appericiated

workers comp

NIPSEY — Mon, 21 Sep 2009 18:04:24 GMT

I was injured on the job a few months ago . The insurance company did not dispute the claim they paid me for approx 2 weeks. The doctor ok it for me to return to work shortly thereafter.What I do not understand is I then received a notice from wcb stating that the case was refer to conciliation process and that the amount of time loss from work was a question and that the proposed decision was that the insurance carrier is responsible for medical treatment.I thought that was established already. What I don't understand is that they received the medical reports from the doctor so why is it that the amount of time is a question .

permanently partially disabled individuals can collect lump

Chanel49 — Mon, 21 Sep 2009 15:44:38 GMT

Hi,

i recently came upon this article which states permanently partially disabled individuals can collect lump sum award vs periodic payments over time. http://www.insurancejo...

Is this for all or just those who are settling with the insurance company ? Please clarify .

Thankyou

Question for Scott/anyone

UpNewYorker — Fri, 04 Sep 2009 21:02:27 GMT

I am pernament partial and 9 years on WC i am still not working and haven't found any job that will hire me. However, at my church they have been asking me to volunteer answering their phones. Reluctantly, i have evaded answering yes or no to avoid answering questions of confusion that could spring that i don't feel like getting into. I do want to do something but feel stuck that i can't. I asked my lawyer and he said that if i do volunteer he would have to inform the IC but didn't say anything more .. and i forgot to ask him if i do will it effect my loss wages payments. Now its labor day weekend and too late to get ahold of my lawyer now. Not sure what to do and if i should just decline the volunteer work. It took years getting my loss wages straighten out and i do not feel like getting drag back into court again for just a few hours of work that will only last 2 weeks. Please advise?

Question for Scott

taz8056 — Sun, 06 Sep 2009 04:14:09 GMT

Had a work related injury back in 2002 which was finally closed in 2007. ( I did leave medical open). I was classifed perm/partial with 80% loss of my hand. Over the past few years, I have started to lose quite a bit of muscle mass in my entire arm due to the fact that my hand is deformed and I cannot lift any weight in excess of 5 to 10 lbs. (the arm is approx. 2-3" smaller then the other). My question is, would I be allowed to re-open the case relating my arm to the original injury? I was recently told by my Doctor and Therapist that my hand will never get any better and because of that, my arm will continue to lose mass. This is what promted me to write to you. As always, will appreciate any advise you can give me.

Thanks

Reimbursement; Time restoration; and Years of Service

gradtogo — Fri, 28 Aug 2009 03:41:44 GMT

Reimbursement:

What is the guideline for reimbursements? Can we claim reimbursement for bridges and tunnels tolls ? What is actually reimbursable?

Time Restoration

What is the guideline for time restoration? I know it is not a 100%. What % ANNUAL or SICK time used for worker compensation is restored?

Years of Service

I wonder when is it that a WC claimant loses years of service calculation. How long do you have to be out of work to have an impact on your seniority? I was out only about a month time all combined between my hospitalizations and convalescence. But I became aware that my years of service were reduced in 2008 by two days. I am recorded at my Pension's records that in 2008 I have completed partial service (11 months and 28 days) 2 days short for full service. This erroneous calculation affects adversely my seniority. I am also concerned that in this economic climate where those with the least seniority risks greater getting laid off or demoted. I have already worked with this Employer 21 years. But am again concerned about the data an my pension office. I do have an opened worker's compensation case since 2007. But again, I have Never taken a prolongued leave. I feel that my employer is spiteful and seeks to lay me off. What should I do? Please help with my questions. Thanks so much.

Fines

brooklyn275 — Tue, 25 Aug 2009 01:54:27 GMT

I had a small corpersation with no employees but hired an occasional freelancer. Went thru a hard time and WC lapsed thru NYSIF in 2006-2007. I just received a notice for $29,000 in penalties and $21,00 in fines for that period. I closed the corp a few months ago and filled for chap 7 personally. What can they do? I have jumped thru hoop after hoop and they keep wanting more info. Just trying to move on

Reimbursement question

NYMike1 — Wed, 08 Aug 2007 14:01:40 GMT

How do I go about trying to get reimbursed for milegae for Dr.'s appt.'s etc. since I've been on WC? What can I get reimbursed for?

Is there a form somewhere that I have to document all the appt.'s I've been to and how many miles? Who do I send it to? WC or IC?

I've tried looking on previous posts to all of these questions but only found bits and pieces.

Thanks for any help that any of you might be able to provide.

i just found this

roystr — Wed, 05 Aug 2009 08:40:51 GMT

i was hurt in 99

i thought i had lifetime medical,since my case was begun prior 2007 law change.

"On the other hand, under the 2007 Legislation, there is now a copy for the length of time you would be able to collect workers' compensation benefits if you are classified with a permanent partial disability. To find out what the length is, check out the Laws and Regulations. So a Section 32 Waiver Agreements may be in your best interest, but again it is suggested that you discuss this matter with your treating physician prior to making a final decision."

http://www.wcb.state.n...

does the above mean one day soon ill be notified that comp is no longer required to cover my work related injury and im on my own?

this obviously has me upset and concerned,

thank you,

roy

3rd party settlements

workerrights — Fri, 07 Aug 2009 00:17:16 GMT

I expect to get a 3rd party settlement from the accident that caused my comp claim .

What part of the NY workers comp will I have to pay back?

Will I be able to collect comp or will the 3rd party settlement end my comp and medical?

10 years in a few weeks

roystr — Fri, 31 Jul 2009 21:02:23 GMT

i was hurt at work 1999

as far as i know,i havent been "classed" yet.

i thought that new law said if we werent classesd,then we would only have so much time to collect our comp,then it all stops and were on our own.

but on my check today,it says im "unschedualed" and now im confused.does "unschedualed" and "classed" mean the same thing?

and what about that time limit?

all im asking,(when they offer to settle) is about 3 to5 years of what im costing them now every year for meds and medical and the rest of it..my meds alone are 110k$ [not counting checks,dr visits,diognosics,etc.... a year as of now. and for the last three years or so.

last i spoke with lawyer,he said he would ask for 600k...we both laughed,,but if they wait 5 years,,thats what they will spend on me anyhow. so its not all that crazy an amount.. taking their money for denying my medical treatment,and meds and various tests year after year,,taking their money is the only thing i have to punnish them with. maybe it wont hurt them,,but ill feel better. if it goes through. thats a very big "if".

so obviously i dont want my time limit to run out and get kicked to the curb.

am i safe just getting my meds and waiting untill they spend enough to want to be rid of me?

not that i see any other options anyways. sigh

thanx alot,

roy

NYS workers compensation and social security disabitity

tammy6407 — Thu, 30 Jul 2009 13:48:46 GMT

I have been on workers compensation since 2004 . I recently went to court for social security disabilty. They founded me disabled thru social security disability . and will be receiving social security disability benefits . Now with workers compensation i have been working with vesid to retrain me to find a job that i am able to do . Am i still required to look for work even though i am now going to be recieving social security benefits and they found me to be disabled? I am doing a retraining pprogram with a computer lab which i am having difficulties sitting and get migrain headaches . How does that work if i am found disabled thru social security while on workers compensation?... I hope my question makes sense .

Scott help -please tired and angry in philadelphia

zrbcolor63 — Fri, 31 Jul 2009 03:19:51 GMT

i have been on WC for 7 yr now , for the past 2 yr all i have done is go to my doctor once a month get my med period that it.

i have gain 30 pound since my accident, every time my doctor send me for anything that he and me think might help me, i go and then told by the person that they have to call my insurance then my ins does not respond next thing you know i get no service since i live in philly and have a NY WC no one here want to deal with me without frist getting the okay from insurance.

i beleive i should get help to lower my weight since it a direct cuase of my injury 4 bad disc , nerve damage ,

i would like to get me a primary doctor in staten island ny and a pain mangement doctor too. i am on very high med been on now for over 6 yr. point is

1) would it be easier for me to get insurance to pay for stuff if i was to have doctosr from nyc???? or it true what one dr i seen told me in nyc once the wc case get old it diffcult to get insurance to do anything plus pain medication is harder to come by in nyc.

it seem that there is a wave of hardship for those of us who take pain med. the dea and lots of doctors even pain magement doctors are unwilling to give you med because they are scared of the DEA.

2) is there a group who is fighting for our right to have our doctor give us what he and us think we need in order to make it thru the day without killing oneself or other because of the constant PAIN we are inEVERY SINGLE&nb... every minute of ever single days. very frustrating when even the doctor who are swore to help you don't for fear of our gov't.

any help with this is very welcome

Employer Keeps reopening Case, Has no Cause, Can I Sue?

Redhood — Sat, 25 Jul 2009 20:35:04 GMT

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In May of 2008 I got hurt pretty bad on the job, I still haven't recovered. I went to the hospital after telling my manager of it, she recommended I do so. I filled out an accident report. The Injury was not my fault but irresponsibleness on part of management.

Before I could come back to work I had to see a doctor. He was insured with my employer. The doctor said I could go back to work light duty with restrictions. When I went to see my Human Resource manager he told me that light duty wasn't an option here and basically sent me home. I was to give him doctor notes each week when I saw the doctor. I did so, he also told me he would be mailing me a W3 forum for workers comp.

I never received it in the mail. 3 weeks later and not receiving any pay I applied for workers comp myself. As soon as I did, my employer sent me a letter dated that I can work light duty in the maintenance department. (That was my old department before I was promoted, not the department that the accident took place, also I didn't work in that department for a little over 4 months before the injury accord. Lastly I believe and it was proven during my Workers Comp hearing that I couldn’t do the work they were asking of me on the letter.)

The letter was sent on the same day the date and time I had to be schedule on, which was June 20, 2008 at 11AM. As I remember I didn't received the letter until either that evening or within two days after the letter was apparently scheduled. So even if I did want to start work again I would have never known of their date on time.

I soon got a lawyer for Workers Comp. I also applied for unemployment benefits. My Workers Comp Attorney told me as long as I don't make over $425 and since I can work but with restrictions I can collect both.

For the pass year and a half I have been continuously being reopen by my employer my unemployment case which they first filed back in July of 08 against me. I have now been there 3 times. The first time their witness was sick so they closed it. Then the second time the Judge at the hearing told them he didn't understand what they were here for even through all their paper work. I also asked for an extension until I could get an attorney, the judge granted me this.

This third time I had an attorney present with me, and the hearing is schedule for a continuum because the Judge couldn't get one of their witnesses on the phone.

It looks like I have a fair advantage in winning this case.

Questions

If the judge rules in my favor and the letter they sent me to go back to work was not possible for me to receive and my employer laid me off with no probable cause could I sue them for discrimination on the grounds of my disability?

I'm not to sure about Unemployment law details, but I remember reading in a Workers Comp law book that you can sue the insurance company or employer for purposely prolonging judgment or payment if you can show proof.

Is their anything outside unemployment jurisdiction that I have grounds to sue. Or how can I propose these grounds to my attorney?

Thank You

Charlie

RE: Wage expectancy, Open medical conversion to settlement.

thebluecoat1 — Tue, 21 Jul 2009 00:10:23 GMT

Hello all,

I have a question regarding wage expectancy, it was recently determined by a WCB judge ruled in my favor that I am found to be 25% partially disabled due to a back injury I sustained a little over 2 years ago (I am 23 years old now). My lawyer said I had to wait until 2 years after the date of accident to file a claim for wage expectancy (which has been filed). He also wrote that I had a slight interest in settling my matter via section 32 for $75,000.

What exactly is wage expectancy at a 25% permanent disability, when I was making $7.48/hr (2007), and highest gross being $9,779 according to my W-2 statement. Do I get a check monthly for the rest of my life? My raise was always the same every 6 months which was 25 cents, so assumingly I would have been making $9.98/hr if I was there until I turned 25, what would be the lamiano for this?

Is it in my interest to seek wage expectancy, or settle via section 32, any advice would be appreciated.

Thanks.

Disability vs Vacation time

taz8056 — Wed, 15 Jul 2009 09:16:33 GMT

Not sure if this is the right forum for this question, if not I apologize in advance.

Next Monday I am having surgery in which I will be out of work for 3 to 4 months. (Not work related). I understand that I must be out of work 7 days before I can start collecting disability. However, my place of employment is telling me that prior to filing any disability claim, I must first use whatever vacation time I have accrued. Is this a true statement? By the way, this was verbal as there is no written company policy that verifies this.

thanks in advance

surgery approval

retiredpokerman — Sun, 05 Jul 2009 09:18:01 GMT

How long is considerd normal for approvals on surgery from state ins ?

Just Tired of being bothered by WCB

Viv55 — Fri, 03 Jul 2009 23:15:33 GMT

Hello everyone I'm new here and have lots of questions to ask about my case. I have been on comp since 2002 had back surgery in 2006. My surgery resulted in failed back syndrome with permenant nerve damage in my leg and foot. I now have a spinal cord stimulator implant in place which eases the pain a little. My Ortho doc recomended social security at this point and I was approved to my surprise. I went to an IME and this doc said that I had a marked now I thought that meant 75% disable if I'm wrong please let me know. Right now they want a hearing to reduce my payments I was reading the RFA and it says that the IME doc found me to have a moderate disability is that the same as marked. I'm just trying to see how they reach there determination. One more thing once you become disable by ssa determination what is the next step with W/C because I'm so tired of them.

TID

GINSWEET — Tue, 07 Jul 2009 21:57:50 GMT

How do you go about being reclassified from PTD to TID. My husband is 50 and has damaged his hands from chemical burns and has very limited use of them (bathing and such). He has Attention Def. Dissorder and a High school education with very limited skills. He has always been a laborer until his injury. He is also on Paxil for his nerves. He has been disabled for 11 years so far with no chance of him getting better. Our lawyer wants him to look for work "with-in his limitations"??? What work can you get when you can not use your hands? What is the process that we have to go through to have him reclassified to TID and what is you "opinion" on his chances for reclassification. (it sounds like very few workers have been reclassified so far).

Thanks So Much

Man tries to shoot at turkey, hits private investigator inst

AGEDONE — Sat, 30 May 2009 14:16:09 GMT

Annsville, Oneida County (WSYR-TV) – A private investigator was shot and injured Friday by an Oneida County man who thought he was shooting at a turkey.

Oneida County Sheriff’s deputies say William Wehnke, 50, of Taberg, saw a turkey in a corn field between his Briarwood Lane home and some woods, and went through the woods, located in Annsville, to try to shoot at it.

As Wehnke went to shoot the turkey, it ran into the woods. Deputies say Wehnke then fired at what he believed to be the turkey, and the shot struck Matthew Brady, 26, from Green Brook, New Jersey.

Deputies say Brady was hit in the side, back and legs. They say Brady is a private investigator who was sent to Taberg to investigate Wehnke’s worker’s compensation case.

Dressed in dark clothing, Brady was lying in the woods, performing surveillance at the time he was shot, deputies say.

Deputies say Wehnke and Brady had never contacted one another before the incident, and neither was aware the other person was in the woods.

Brady was taken to St. Elizabeth’s Hospital, where he is listed in serious condition as of Friday afternoon.

Wehnke was later arrested on an assault charge. He was arraigned in the Town of Floyd court, and was sent to jail with bail set at $15,000.

I do not think The guy should have went to jail!! I do not think he is a flight risk. Other than that I am not saying. LOL Not funny I know