Workers’ compensation benefits are not paid for the first seven days of a job-related disability, unless the disability extends beyond 14 calendar days. Benefits are based on the average weekly wage (AWW) earned by the employee during the 52-week period immediately prior to the accident. The maximum weekly benefit rate is equal to two-thirds of the AWW in New York State, subject to the degree of disability.
Medical benefits are paid by the insurance carrier.
Survivor benefits payable to a spouse, and/or other dependents, are paid if an injured worker dies from a job-related injury or illness. Paid funeral expenses are subject to statutory maximums.
NYSIF payments to claimants may be delayed for any of the following reasons:
- Lost time does not exceed seven calendar days (if lost time does not exceed 14 days, the first week is not payable)
- NYSIF received no medical evidence of a causally-related disability beyond seven days
- The employer is paying full wages
- NYSIF is waiting for evidence substantiating dependency in death cases
- NYSIF is disputing the claim on behalf of the policyholder
If none of these reasons apply to a delay in your payments, contact your case manager.
Section 32 Settlements
Section 32 Waiver Agreements are a negotiated agreement between the injured worker and the insurance carrier to settle benefits on a claim. A waiver agreement ends the right of an injured worker to ongoing and future benefits in exchange for a lump sum payment or an annuity. The New York State Workers' Compensation Board video Settling Your Claim explains the implications of aSection 32 Waiver Agreement on your claim. The WCB requires that claimants watch the video before they enter into a waiver agreement.