Workers' Compensation cases come in all shapes and sizes, lengths and durations. Within each case there can be a variety of timelines, so let's get into them!
One of the first things people wonder after filing a workers' comp claim is, “How long is this going to take?”
On average, most cases take anywhere from 12 to 24 months from start to finish. That might seem like a long time, but a lot of factors can affect the timeline.
If your injury is something minor—like a sprained pinky finger—your case could move along pretty quickly. But if you’ve got a more serious injury that needs surgery and a long recovery, it’s probably going to take longer.
Temporary wage benefits are a big part of workers' comp—they’re there to help you financially while you're off work because of your injury. Knowing how they work and when they’ll stop is super important for keeping your finances in check during this time.
How Long Do Temporary Wage Benefits Last?
These benefits cover you while you're recovering and can’t work. You’ll usually get about two-thirds of your average weekly paycheck. How long you’ll receive them depends on how serious your injury is and how long it takes for you to reach something called Maximum Medical Improvement (MMI), which basically means you've healed as much as possible.
Different Types of Temporary Disabilities
There are a couple of different categories of temporary disabilities, and they impact how your benefits work:
What Happens When Temporary Benefits End?
These benefits stick around until you hit MMI. Once your doctor says you’ve recovered as much as you're going to, they’ll check to see if you have any lasting disability. If you do, your temporary benefits will end, and you might start receiving permanent disability benefits depending on how much your injury affects your ability to work.
The approval process for medical treatment—like surgery—under workers' comp can take anywhere from a few weeks to a few months. Insurance companies typically have about a month to review and respond to your doctor's request once it’s submitted.
Delays are pretty common when it comes to getting treatment approved, and they usually happen for a few key reasons:
And of course, if your treatment gets denied, the appeal process can stretch things out even longer—sometimes by several weeks or even months.
While you can’t control everything, there are a few ways to help avoid unnecessary delays and keep the process moving as smoothly as possible:
IMEs can be scheduled at pretty much any stage of your case, and the timeline can vary depending on the situation.
Here’s a rough idea of how long it can take:
If the insurance company misses their deadline to schedule the IME, they could lose their chance to do it. However, in most cases, judges tend to give them another shot if they have a valid excuse.
Why Do IMEs Happen?
IMEs can come up for all kinds of reasons, and they’re usually at the request of the insurance company. Some of the most common reasons include:
What Happens if You Miss an IME?
If you skip an IME, it can throw a wrench in your case. Missing an appointment usually means the insurance company will just reschedule it, which can drag things out even longer. But if you keep missing them, it could hurt your case—possibly leading to a suspension of your benefits.
If you can’t make it to an IME for a good reason—like an emergency or a scheduling conflict—be sure to let your lawyer know right away. They can help you reschedule and avoid any negative impact on your case.
How to Cut Down on IMEs
Even though IMEs are a standard part of the process, there are a few ways you can avoid having to deal with them too often:
On average, it takes anywhere from 30 to 90 days to get a hearing scheduled, but things like how busy the system is, the judge’s availability, and even the time of year can cause delays. If the insurance company misses their deadline to request a hearing, they could lose their chance—though judges sometimes give them another opportunity if there’s a good reason.
What Happens During a Hearing?
If you’ve never been to a hearing before, don’t worry—it’s not like what you see in courtroom dramas. That said, it’s still an important part of your case, so it’s good to know what to expect:
How to Avoid Delays and Keep Things Moving
While hearings take time, there are a few things you can do to avoid extra delays and make sure everything stays on track:
Here’s a general idea of what to expect based on your situation:
Schedule Loss of Use (SLU) Injuries
If your injury involves body parts like your arms, legs, hands, feet, fingers, or toes, the typical guideline in New York State gives you about a year from your accident or surgery to hit MMI.
For example, if you break your arm on January 1st but end up having surgery on March 15th, your one-year timeline resets to that surgery date.
That said, recovery is different for everyone. Some people might hit MMI in as little as eight months, while others might take two or three years, depending on how serious the injury is and how well treatment goes.
Non-SLU Injuries
For injuries that don't fall under the SLU category—like neck and back injuries—reaching MMI usually takes around two years.
These injuries tend to need more time and ongoing care, so the workers' comp board gives you a bit more breathing room before they start pushing for a final evaluation.
What Can Affect How Long It Takes?
Several things can influence how quickly (or slowly) you get to MMI, including:
A few key things play a role in how fast you can return:
Sometimes, people go back to work before they’re fully healed because they need the paycheck. While that’s understandable, it can create issues—especially if your medical records still say you’re totally disabled.
What Affects Your Return-to-Work Timeline?
There are a few big factors that can impact when and how you can go back to work:
Understanding Full Duty vs. Light Duty Work
Going back to work doesn’t always mean jumping right back into your old job the way it was before your injury. There’s a big difference between full duty and light duty:
However, if your salary stays the same even with reduced physical demands, workers' comp won’t consider you to be on light duty.
It can take anywhere from a year to two years or even longer, depending on your injury and how your recovery goes. There’s no exact timeline, but here’s a general idea of how things usually play out.
If you’re dealing with a Schedule Loss of Use (SLU) injury, like damage to your arms, legs, hands, feet, fingers, toes, vision, or hearing, you're usually looking at about a year from the date of your injury or surgery to get your rating.
For non-SLU injuries, like back or neck problems, expect the process to take around two years before your impairment rating is finalized. These cases can be more complicated, requiring longer monitoring and evaluation.
Keep in mind—these timelines aren’t set in stone. Some cases take much longer, especially if you're still going through treatment or dealing with complications.
Getting an accurate impairment rating depends a lot on whether your doctor really knows how the workers' comp system works. They need to be familiar with the guidelines and know how to properly evaluate your injury. If they don’t follow the right procedures, it can lead to delays, lower ratings, or even disputes with the insurance company.
If you’ve got a permanent injury to a specific body part—like a 10% loss of function in your shoulder—you’ll likely get a Schedule Loss of Use (SLU) award. This usually comes as a one-time lump sum payment. But before they send the check, the insurance company will take a look at any payments they’ve already made and adjust your final amount. Once everything is finalized, it typically takes a few weeks to process and get your payment.
A Section 32 settlement is a “one and done” kind of deal. It’s a lump sum payment that settles your workers' comp case for good—meaning no more claims or payments in the future. This type of settlement is something you negotiate with the insurance company. Once a judge signs off on it, you’ll get a single big check that covers everything. It usually takes 4 to 8 weeks after approval to receive your money.
If your injury affects your ability to work in the long run—like a neck or back injury—the judge might decide on your Loss of Wage Earning Capacity (LWEC). If they say you have a 30%, 40%, or higher loss, you won’t get a lump sum. Instead, you’ll receive weekly or biweekly payments, just like when you were getting temporary disability. These payments usually start shortly after the judge’s decision and will continue for a set period based on how much of a loss they determined you have.
One of the biggest holdups of settlements? The insurance company’s response time. Some companies are quick to review settlement demands and get back to the table, but others? They can take their sweet time—sometimes months—before even giving you an answer. If they’re swamped with cases or just not in a hurry to settle, it can feel like you’re stuck in limbo with no end in sight.
The complexity of your case is another big factor. If your injury is pretty straightforward and the medical evidence is clear, things tend to move faster. But if there are questions about how serious your injury is, whether you need more treatment, or if pre-existing conditions come into play, things can slow down. The more back-and-forth needed to sort out the details, the longer it’ll take to reach a settlement.
Experience also counts. If you’re dealing with an insurance adjuster who knows what they’re doing and is open to working with you, things can run pretty smoothly. On the flip side, if they’re inexperienced or unorganized, it can take way more back-and-forth to get things sorted out.
If your workers' comp claim gets denied, it basically means the insurance company thinks they shouldn’t have to pay up—and fighting that can stretch your case out for months or even years.
Insurance companies deny claims for all sorts of reasons. Maybe they don’t think there’s enough medical proof to back up your injury, or their investigation says the accident didn’t happen the way you said it did. They might argue that you didn’t report it in time, had a pre-existing condition, or aren’t following your treatment plan. No matter the reason, once your claim is denied, things start to slow down—a lot.
When this happens, your next move is usually going to trial, where you’ll have to lay out all the evidence and prove your case in front of a judge. While some trials wrap up quickly, most take multiple hearings. That means witnesses, medical records, and a lot of back-and-forth between lawyers, with hearings spaced out over weeks or even months—making your case take even longer.
And even after all that, it’s not necessarily over. If you lose at trial—or even if you win—the other side can file an appeal, which just adds more waiting to the mix. Appeals can take several months, and until a decision is made, your case stays stuck in limbo.
Appeals can stretch your case out for months or even years, depending on how complicated things get. If the judge makes a decision that one side isn’t happy with—whether it’s you or the insurance company—either of you can file an appeal. And let’s be real, appeals happen a lot.
Once a judge makes a ruling, you usually have 30 days to file an appeal. Then, the other side gets another 30 days to fire back with a rebuttal, explaining why they think the original decision should stand. After all the paperwork is in, it gets sent to the Workers' Compensation Board for review. This is where things really slow down—sometimes you’ll get a decision in a few weeks, but other times it could take six months or more before you hear anything.
If you don’t like the outcome at this stage, you can take things to the next level—like the state appellate court—but that means even more waiting. Keep in mind, though, not all appeals move forward. Some get denied right away, depending on the circumstances.
The tough part about appeals is that they put your case in limbo, which means your settlement gets pushed back even further. But here’s the upside: a good workers' comp lawyer knows how to handle appeals and push things along as quickly as possible.
Filing Problems
Getting your claim in on time and done right is super important. Waiting too long to report your injury or submitting incomplete paperwork can lead to disputes and hold up the process. Missing details often mean corrections and resubmissions, which only add more time.
Medical Treatment Delays
If your injury needs multiple treatments or surgeries, expect a longer timeline. Follow-up procedures or extended recovery periods can push things back even further. The longer it takes to reach maximum medical improvement (MMI), the longer your case will take to settle.
Slow Settlement Negotiations
Reaching a settlement takes time because both sides need to agree on terms. If there are disagreements about how much your claim is worth, negotiations can drag on. Insurance companies aren’t always in a rush to respond, especially when they’re handling a bunch of other claims too.
Communication Issues
Staying engaged in your case is key. If you're slow to provide documents or respond to your lawyer, it can stall progress. Switching lawyers or struggling to stay in touch with your current one can also cause setbacks. Keeping open and regular communication helps keep things on track.
Appeals Can Stretch Things Out
If your case goes to appeal, get ready for a longer wait. There are strict deadlines for filing and responding, but once everything is submitted, it can take months to get a decision. Appeals add more time and can keep your case in limbo.
Unexpected Hold-Ups
Some delays are beyond your control. Courts and workers' comp boards can get backed up with too many cases, slowing down hearings and paperwork. Holidays, staff shortages, and even public health crises (like COVID-19) can also delay things by limiting the availability of key people in your case.
Find a Good Lawyer
A workers' comp lawyer who knows the system inside and out can make a big difference. They’ll handle the paperwork, meet deadlines, and communicate with the insurance company to keep your case on track.
Choose the Right Doctor
Your doctor plays a huge role in your case. A doctor experienced in workers' comp claims knows how to provide the right documentation and follow treatment guidelines to avoid hold-ups with approvals.
Stay Organized and On Top of Things
Keep all your medical records, doctor’s notes, and case-related paperwork in one place. Respond quickly to requests from your lawyer, doctor, or the workers' comp board to prevent unnecessary delays.
Don’t Miss Appointments
Showing up for every medical appointment and hearing proves you're serious about your recovery. Missing them can slow things down and raise questions about your claim.
Keep Communication Flowing
Stay in touch with your lawyer and keep them updated on any changes in your health, treatment, or work status. If you’re heading back to work, make sure your employer knows about any restrictions or accommodations you need.
Know What to Expect
Understanding the workers' comp process helps you stay ahead. Knowing what steps come next—like filing, medical evaluations, and settlement negotiations—can help you stay prepared and avoid surprises.
Be Patient but Stay Involved
Workers' comp cases take time, but staying proactive can help speed things up. Follow up with your lawyer and doctor regularly, and don’t hesitate to speak up if something seems off.
Whether you have questions about your specific situation, need assistance with paperwork, or just want to understand your options better, don't hesitate to reach out.
You can call me, Rex Zachofsky, directly at 212-406-8989. Let's work together to ensure you get the benefits and support you're entitled to.Looking forward to helping you with your case!
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