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 a Section 32 Waiver Agreement on your claim. The WCB requires that claimants watch the video before they enter into a waiver agreement.