Settling Your New York Workers' Compensation Case

New York workers' comp helps cover lost wages and medical care if you get hurt or sick because of your job. Most claims end with a settlement, where you and the insurance company agree on either a lump sum payment or a set schedule of payments. I'm going to walk you through the different types of settlements, explain the step-by-step process for settling your claim, and share some tips on how to get the best settlement possible.

Types of Workers’ Comp Settlements

In New York, there are two main types of workers’ compensation settlements: stipulated agreements and Section 32 waiver agreements. Both of these settlements are tax-free.

Stipulated Agreements

A stipulated agreement is basically a deal between you and the insurance company about how serious your disability is and how much money you’ll get. You can use this type of settlement for both Schedule Loss of Use (SLU) cases and permanent partial disability cases, but it’s more often used for settling SLU of an injured arm, leg, hand, or other extremity.

One of the perks of a stipulated agreement is that it can be reopened if your condition gets worse. If that happens, you can ask the New York Workers’ Compensation Board to reopen your claim for more treatment and to reevaluate your level of disability or impairment.

Section 32 Waiver Agreements

A Section 32 waiver agreement means you’re giving up your right to ongoing benefits in exchange for a lump sum payment. Basically, you’re “waiving” your right to ask for more benefits down the road. This type of settlement usually means your claim is fully and finally closed, so you won’t get any more money or medical coverage related to the injury.

In some cases, you can go for an “indemnity only Section 32 agreement,” where the settlement only covers the cash part of the claim, but the insurance company still has to pay for your ongoing medical care related to the injury.

Once a full and final Section 32 agreement is done, it’s a done deal—you can’t reopen it, even if your condition gets worse or you need more medical treatment.

How Does the Settlement Process Work?

The settlement process involves negotiating with the insurance company. Here’s a step-by-step breakdown:

1. Initiation: You or your lawyer can approach the insurance company, or vice versa. The insurance company might initially offer a low settlement.
2. Negotiation: Don't be discouraged by a low initial offer. Your lawyer is obligated to present any offer to you, but negotiations will continue until a fair agreement is reached.
3. Drafting the Agreement: Once terms are agreed upon, either the insurance company or your lawyer will draft the settlement agreement.
4. Review and Hearing: The agreement is submitted to the New York State Workers' Compensation Board, which will schedule a settlement hearing with a law judge.
5. Cooling-Off Period: After approval, there is a 10-day cooling-off period during which either party can back out of the settlement by providing written notice.
6. Final Approval and Payment: Once the cooling-off period passes without withdrawal, the Workers’ Compensation Board files a Section 32 notice of approval. The insurance company then has ten days to pay the award.

How to Maximize Your Settlement

Maximizing your workers' compensation settlement involves several strategic steps:

1. File Early: Submit your claim as soon as possible to avoid delays and potential complications.
2. Keep Records: Meticulously document all out-of-pocket medical and travel expenses related to your claim, as you are entitled to reimbursement.
3. Avoid Recorded Statements: Do not provide recorded statements to the insurance company without consulting your lawyer, as these can be used to devalue your claim.
4. Be Transparent with Doctors: Communicate openly with your treating physicians and the insurance company’s consulting doctors about all injuries, including those that may have improved or new pain that develops over time.
5. Hire a Lawyer: Having an experienced workers' comp lawyer can significantly increase your settlement amount. They know how to effectively negotiate with insurance companies and can advocate on your behalf.

Contact Us For Help With Your Workers' Compensation Case

If you or a loved one has been injured on the job in New York, a free consultation can be the first step towards securing the settlement you deserve. Call me, Rex Zachofsky, at 212-406-8989 today.

For more detailed information about stipulated and Section 32 waiver agreements, visit the New York Workers’ Compensation Board's official page.