Workers’ compensation insurance is designed to protect employees who get hurt on the job. These policies typically cover health care expenses and some portion of the injured party’s lost wages. Navigating the claims process can be challenging, and it is common to have a lot of questions following a serious work accident. Below, the legal team at Vincent J. Criscuolo & Associates in Rochester, NY, answers a few of the most common inquiries on the subject. 

4 FAQs About Workers’ Compensation

Does Fault Affect Eligibility?

In most cases, employees who played a role in the incident that caused their injuries are entitled to workers’ compensation benefits. Fault does not typically play a role when it comes to eligibility unless the employee was under the influence of drugs or alcohol at the time of the accident or was intentionally trying to sustain or inflict an injury. 

What Kinds of Injuries Are Covered?

Virtually any injury you sustain while on the job is covered under your employer’s workers’ compensation insurance. Occupational diseases like carpal tunnel syndrome and post-traumatic stress disorder are also covered. To receive benefits for an occupational disease, though, you must prove how you developed it over the course of your employment. 

Do You Have to Visit an Approved Provider?

In New York, claimants must visit an authorized provider for their employer’s insurance company to cover the cost of medical care under the workers’ comp policy. You can find a list of authorized providers by location on the state’s Workers’ Compensation Board website. 

Can You Appeal a Denial?

If you hire an attorney at the start of the claims process, you can avoid making critical mistakes along the way that might result in a denial. Fortunately, those who do file on their own and receive a denial can appeal the decision before a workers’ compensation law judge. In such scenarios, it is wise to seek legal counsel before proceeding. 

If you need help navigating the claims process for workers’ compensation benefits, turn to Vincent J. Criscuolo & Associates in Rochester. They are passionate about representing vulnerable, injured, and disabled individuals who are not getting the financial assistance they deserve. Visit the firm online or call (585) 232-3240 to schedule a free case evaluation with an attorney on their team.