Many people who are unfamiliar with the workers’ compensation system in New York may think that getting these benefits is just “automatic” when they suffer an on-the-job injury or contract an illness due to their employment. But, the fact of the matter is that sometimes workers’ compensation claims are disputed. When they are, you may find yourself in a hearing in which you will need to prove that you are entitled to workers’ compensation benefits.
Hearing basics
First, our readers should know that, in theory, the workers’ compensation system is indeed supposed to be pretty much “automatic.” In essence, the whole basis of the system is that employers are entitled to be shielded from legal liability, while employees get benefits if they are hurt on the job. Employers have workers’ compensation insurance for this purpose. However, there are situations in which an employer or the employer’s insurance company will dispute a claim.
Disputes may arise if, for example, an insurer: doesn’t believe a policy was in effect; doesn’t believe the employee was actually injured on the job; or maybe doesn’t even believe there is an injury at all. Of course, there could be other reasons as well. When it comes time for a hearing on your claim, it pays to be prepared.
The hearing will occur with a workers’ compensation judge presiding over the proceedings. All of the facts of the situation will be reviewed, including any medical records that were prepared due to the injury or illness in question. The employee’s wages will be examined as well. And, to a certain extent, persuasive arguments can be made to try to get the desired result. Ultimately, the decision is in the judge’s hands, including the decision on any amount of award.