Suffolk Worker Compensation Eligibility Guidelines

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worker's compensation eligibility guidelines

A workers’ compensation lawyer specializing in eligibility guidelines can provide valuable assistance in understanding the workers’ compensation guidelines. The first step is to determine whether your employer carries workers’ compensation insurance. Our team will ensure that you have a clear understanding of your situation.


In New York State, all businesses with three or more workers are required by the Workers’ Compensation Board to have workers’ compensation insurance. If you’re uncertain about your employer’s coverage, you can easily search the New York State Workers’ Compensation Board database.

If you have doubts about your eligibility for benefits, our Suffolk eligibility guidelines attorneys are here to help. We offer free consultations to help you understand who qualifies for workers’ compensation in New York State.

To be eligible for New York State workers’ compensation benefits, the following conditions typically need to be met:

  • You were not intoxicated or impaired at the time of the accident.
  • You did not intentionally cause the accident.
  • You are employed by an organization that carries workers’ compensation insurance.
  • You sustained an injury or occupational disease as a direct result of your job.


If you require legal assistance regarding eligibility guidelines in Suffolk, call our lawyers at (212) 463-8888 for a free consultation.


There are certain categories of workers who are generally not covered by New York State workers’ compensation laws. These include:

  • U.S. government employees
  • Farm laborers
  • Domestic servants
  • Railroad workers
  • Self-employed individuals
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Suffolk Worker Compensation Practice Areas

Workers' Compensation Insurance Covers Both Injuries And Illnesses

According to the New York State Workers’ Compensation Board mployee Handbook, if a disease meets specific legal criteria, the employee may be compensated. However, there must be a clear connection between the disease and the worker’s employment. New York State classifies work accidents into two categories: catastrophic and non-catastrophic. Workers’ compensation covers injuries resulting from both types of accidents, but different types of benefits may apply to each. Catastrophic injuries covered under workers’ compensation include;

  • Amputations
  • Severe paralysis
  • Severe head injuries
  • Severe burns
  • Blindness
  • Injuries that prevent employees from returning to work.

Non-catastrophic injuries encompass most other types of injuries that do not permanently and completely prevent an injured worker from returning to some form of work. Depending on the severity of your injuries, our Suffolk workers’ compensation lawyers may be able to secure compensation for lost wages due to temporary or permanent disability, as well as future wages.


When evaluating your damages, your personal injury attorney will consider the following factors to determine a fair settlement:


Financial Losses

This includes medical bills, property damage, and lost wages. Your attorney will gather evidence such as receipts, bills, repair estimates, and expert testimonies to assess your current and future expenses resulting from the accident.


Personal Losses

These encompass physical pain, emotional suffering, and mental distress. While it is challenging to assign a precise monetary value to personal losses (also known as non-economic damages), they are just as significant as financial losses.


Punitive Damages

It’s important to note that punitive damages can only be ordered by the court and are relatively rare. Your attorney will inform you if your case may qualify for punitive damages.

Our ultimate goal is to secure a settlement or verdict that enhances your quality of life and provides for future treatment. Therefore, we will diligently pursue the maximum appropriate compensation through negotiations or trial.


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Types of Workers That are Ineligible for Workers’ Compensation

Certain workers are ineligible for workers’ compensation in Suffolk as per state law. These include;

  • Independent contractors
  • Freelancers
  • Consultants
  • Farm laborers
  • Railroad workers
  • Longshoremen
  • Volunteers, and some domestic workers. 

These individuals are responsible for their own income taxes, and their classification as exempt in their 1099 forms prevents them from receiving workers’ compensation benefits.


Key Factors That Affect Workers’ Compensation Eligibility

Your employer’s insurance company may deny your workers’ compensation benefits under specific circumstances, such as:

  • If you intentionally caused your injury or illness or 
  • If it resulted from your willful misconduct. 

However, if your alleged impairment did not cause the accident, you have the right to request a hearing to challenge the denial, and our workers’ compensation lawyers can assist you in this process.


How Georgia Considers Injuries When a Worker is at Fault

The New York State Workers’ Compensation Board does not provide benefits to workers who are willfully or negligently at fault for causing their workplace accidents. There is a distinction between accidents that could happen to anyone in the same situation (covered by workers’ compensation) and accidents resulting from an employee’s willful misconduct or negligence (not covered by workers’ compensation).


Bad Acts That Could Squash Your Workers’ Compensation Eligibility

Certain bad acts can render a worker ineligible for workers’ compensation benefits. Examples include;

  • Violating the employer’s code of conduct related to workplace safety
  • Engaging in physical altercations with coworkers or superiors
  • Working while intoxicated. 

Workers who become intoxicated through exposure to workplace chemicals or toxins may still be eligible for benefits, but those who are voluntarily intoxicated will likely be ineligible.

If you need further clarification or assistance with workers’ compensation eligibility guidelines, please don’t hesitate to contact our Suffolk workers’ compensation lawyers. 


Complete a free case evaluation form or call us at (212) 463-8888 today. 


If you’ve been injured at work and want to know if you’re eligible for workers’ compensation benefits, it’s crucial to consult a workers’ compensation lawyer who specializes in eligibility guidelines. They will provide legal assistance and ensure you understand the criteria for workers’ compensation in your specific situation.


In New York City, workers’ compensation eligibility can be complex, especially if you work for a small company or are unsure if your employer carries workers’ compensation insurance. Our team of experienced New York City workers’ compensation eligibility guidelines lawyers at Gabriel Legal Injury Lawyers can provide the answers you need.

Engaging In Horseplay In The Workplace

Participating in horseplay or initiating pranks can impact your eligibility for workers’ compensation benefits. If you were injured due to horseplay or a prank you started, you may be ineligible. However, if you were an unsuspecting victim of such activities, you are likely eligible for workers’ compensation benefits. In this case, the responsibility lies with your coworker rather than yourself.

Suffering Injury from Off-the-Clock Accidents

If you experience an accident while off the clock but still on the worksite, you might be ineligible for workers’ compensation. Typically, workers engaged in non-work-related activities during lunch breaks or smoke breaks are not covered. However, certain exceptions may apply, and our workers’ compensation eligibility lawyers can assess your situation to determine if you qualify for benefits.


Becoming Injured on the Clock but While Deviating from Your Normal Duties

Injuries sustained while deviating from your regular work duties may affect your eligibility for workers’ compensation. If you engage in activities outside the scope of your job without authorization and suffer an injury as a result, you may be ineligible for benefits. For instance, a delivery driver who makes a personal stop while on the clock and gets into an accident outside of their job duties may not be eligible for workers’ compensation benefits.

Other Factors That Could Affect Your Workers’ Compensation

In addition to the eligibility requirements discussed above, there are other factors that may influence your ability to collect benefits from your employer’s workers’ compensation plan.

Prompt Reporting: It is crucial to report any on-the-job accidents promptly to your supervisor. Failure to report your injury within 30 days may result in the loss of workers’ compensation benefits.

Choice of Medical Provider: New York State law mandates that employers provide a list of approved medical providers for treating work-related injuries or illnesses. You can choose from this list, which typically includes at least six physicians. Alternatively, you can contact a representative from the Workers’ Compensation Managed Care Organization contracted by your employer for medical services.


Working at a Lesser Paying Job: If your injury prevents you from returning to your previous position and you accept a lower-paying job, you may still be eligible for workers’ compensation. However, the benefits you receive will be reduced and should not exceed $450 per week. These benefits are limited to a maximum duration of 350 weeks from the date of your accident.

Catastrophic Injury: If you sustain a catastrophic injury, you may be eligible for lifetime benefits. For other types of injuries, benefits can be provided for up to 400 weeks.

Social Security Payments: It is possible to receive both Social Security and workers’ compensation simultaneously. However, receiving worker’s compensation benefits may affect the amount of your Social Security benefits.

Frequently Asked Questions

Call for a Free Consultation Today

At Gabriel Legal Injury Lawyers, we understand the importance of immediate action and prioritizing your needs. Our team of experienced lawyers is committed to tirelessly advocating for your rights and will not give up until your case is settled. When you choose our firm, you can rest assured knowing that we have your best interests at heart.

After experiencing a workplace accident, it’s essential to have the guidance and support of skilled Suffolk lawyers. We are here to help you navigate the legal process and ensure you receive the compensation you are entitled to. Your focus should be on your recovery while we handle the legal complexities on your behalf. Don’t hesitate to reach out to us today; the sooner we begin working on your case, the better.

Trust Gabriel Legal Injury Lawyers to fight for your rights and provide the assistance you need during this challenging time. Let us take care of securing your rightful compensation, allowing you to move forward with confidence and peace of mind. Contact us now to schedule a consultation.

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Determining Liability in an Suffolk Personal Injury Claim

Identifying all potential defendants who may be liable for a personal injury requires a thorough investigation. If someone else failed to exercise due care, they can be held responsible for the resulting injuries.

It’s essential to recognize that the person directly responsible for the accident may not be the sole party held liable. For instance, in a drunk driving auto accident, not only the intoxicated driver but also the individual who served alcohol to the visibly intoxicated person could be held responsible.

By carefully assessing the circumstances, an experienced personal injury attorney can determine the parties who may be held accountable in your specific case.

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The sooner you contact a personal injury attorney in Suffolk after an accident, the easier it will be to collect evidence.Having a clear understanding of the negligence laws in your state is crucial when pursuing a personal injury claim. Your attorney will play a crucial role in proving fault in your case. While some states follow “no-fault” laws, it’s important to note that New York does not fall into this category.

It’s important to understand that even if you bear some responsibility for the accident, you may still be eligible for compensation. It’s important to note that New York follows a pure comparative negligence rule, which means that even if a plaintiff is deemed to be more than 50% at fault, they can still recover damages. The amount of compensation they receive will be reduced by their assigned percentage of fault.

Overview of the Personal Injury Lawsuit Process

It’s natural to have concerns about what to expect during the claims process, but rest assured, our experienced lawyers are here to guide you. Here is an outline of the stages you can anticipate:


Initial Consultation

This is an opportunity for you to share your account of the incident and ask questions about the case. The attorney will evaluate the viability of your case and provide appropriate advice before entering a fee agreement.


Case Investigation

Your attorney will conduct a comprehensive investigation, including interviews with you and witnesses, review of your background and medical records, to gather necessary information and determine the best course of action for your case.


Filing Court Documents

Your lawyer will file a personal injury complaint, which serves as the initial document of the case. The complaint outlines the nature of the incident and the injuries sustained, and must be properly served to the defendant along with related documents.


The Discovery Process

This involves the exchange of evidence between the involved parties. Interrogations, document requests, sworn statements, and depositions may be part of the process. Your attorney may also co


Pre-Trial Litigation and Motions

After reaching maximum medical improvement (MMI), your lawyer will demand compensation based on the full extent of your damages. Negotiations with the at-fault party’s insurers will take place to seek a fair settlement.



If an out-of-court agreement cannot be reached, the case will proceed to trial. The jury will determine the defendant’s liability, and if the verdict favors the plaintiff, the defendant will be obligated to compensate for the identified damages.

Arrange Your Free Consultation in Suffolk

Gabriel Legal Injury Lawyers specializes in personal injury cases, handling even the most complex matters. Our legal team is well-versed in the laws and knows how to pursue the compensation you deserve.

Let’s talk

Contact us today for a free consultation and let us assist you in moving forward after this challenging time.

Suffolk Worker Compensation Eligibility Guidelines

4.8 Stars


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