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Workers' Compensation

Overview

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Background

HISTORY

Workers’ Compensation is a form of insurance that provides both cash benefits and medical care for people who are injured or become ill while working or as a direct result of their job. The history of the workers’ compensation program began in late 19th century Europe, where individual countries set up systems to protect workers from accidents on the job, with a ‘no fault’ approach to addressing the financial needs of an injured worker as quickly and efficiently as possible. This concept was soon brought to the United States.

In the early 1900’s, the United States government passed laws at the federal level to regulate American employers’ responsibility to injured workers. Soon after, the responsibility to legislate and enforce these laws was moved to the state level. By the second decade of the 1900’s, individual states started to create laws to govern employers’ financial obligations to injured workers. In New York State, the first Workmen’s Compensation Law was passed in 1913, and became effective in New York on July 1, 1914, thus establishing a system to protect workers who are hurt or who suffer an illness directly related to their job.

Workers’ Compensation is managed at the state, rather than the federal level. In New York, the state legislature has updated and amended the law many times. In 1978, the name of the law was changed to be the Workers’ Compensation Law, reflecting the fact that the workforce is comprised of both men and women.

WHO ADMINISTERS THE PROGRAM

In New York State, the Workers’ Compensation program is administered by the Workers’ Compensation Board, which operates within the New York State Department of Labor. The Board is a state-level agency that processes all Workers’ Compensation claims. The Workers’ Compensation Board can also intervene if there is a question or dispute about an employer or its insurance carrier’s responsibility to pay cash benefits and/or for medical care, and the level of payments.

The Workers’ Compensation Board is made up of 13 commissioners, including the chair, who are appointed by the Governor of the State of New York, and confirmed by the New York State senate. The Board includes a medical appeals unit that exists to review appeals on medical matters.

The Worker’s Compensation Board states its mission is: “…to equitably and fairly administer the provisions of the New York State Workers’ Compensation Law, including Workers’ Compensation benefits, Disability benefits, Volunteer Firefighters’ benefits, Volunteer Ambulance Workers’ benefits, and Volunteer Civil Defense Workers’ benefits law on behalf of our customers, New York’s injured workers and their employers.”

Under the law, an employer is obligated to provide workers’ compensation benefits in one of three ways: by buying insurance from the New York State Insurance Fund (NYSIF), by insuring with a private insurance carrier, or by self-insuring.

FUNDING

The activities of the Workers’ Compensation Board is funded through the State of New York Executive Budget, which is reviewed and submitted each year by the governor, and is approved by the New York State Legislature. Within the budget, the Board is considered a “Special Revenue-Other” funding line. Funds are provided through an assessment levied on the state’s covered employers. Taxpayers do not contribute to the funding for the Workers’ Compensation Board.

Benefits provided under the Workers’ Compensation program are paid for by employers or by the employer’s insurance carrier. New York State requires employers to provide workers’ compensation and disability benefit coverage. All employers must purchase or provide insurance through approved providers or plans that meet State requirements.

Summary of the Workers’ Compensation Program

Workers’ Compensation is a form of insurance provided by employers that pays employees for the medical care, wages and/or cash benefits when employees are injured or become ill while working or as a direct result of their job. All for-profit businesses must provide Workers’ Compensation insurance for their employees. In addition, government workers at the municipal, county and state level in New York State are entitled to Workers’ Compensation insurance. There are some groups, including some non-profit workers, some domestic or casual workers, and independent contractors, who are not covered by the Workers’ Compensation Law.

In the New York State Workers’ Compensation system employers provide insurance at no cost to workers to cover lost wages and medical treatment and rehabilitation.

If a worker cannot resume wage-earning at the same level as before the work-related injury, a cash benefit is provided to make up a percentage of the difference in lost wages. All benefits are processed through the Workers’ Compensation Board.

All benefits, including death benefits to survivors of a worker whose death resulted from a job-related injury or illness, are approved by the state-level Workers’ Compensation Board. If there is a dispute about a claim, it is processed through the Board and its judges and appeal system.

Other Benefits under the Workers’ Compensation Program

SUPPLEMENTAL BENEFITS

A limited supplemental benefit is available to two groups of people who were determined to be eligible for and who were receiving benefits prior to January 1, 1979. The first group includes workers who were classified by the Workers’ Compensation Board as totally disabled before January 1, 1979. The second group includes widows or widowers who were receiving death benefits prior to 1/1/1979. These two groups are eligible for a supplemental benefit of up to $215 per week to compensate for rising costs. Application information for this additional cash benefit can be provided through the State and District Offices, see below, Government Contacts.