If your business has employees in the state of New York, you’ll need to make sure you adhere to New York’s Workers’ Compensation Insurance laws. Workers’ Compensation provides medical and financial benefits for employees who suffer work-related injuries or illnesses or for their survivors in the case of an employee death. 

Who needs Workers’ Compensation Insurance in New York?

New York requires all employers with at least one employee to obtain Workers’ Compensation Insurance. In New York, an “employee” is generally defined as any individual who performs services for another and is not an independent contractor. 

The New York Workers’ Compensation Law (WCL) defines all of the requirements for Workers’ Comp in New York, and the New York Workers’ Compensation Board (WCB) monitors, enforces, and administers the program. Ensuring your company is in compliance is critical, as there are serious penalties and fines for those who fail to abide by state regulations.

What employees are covered under Workers’ Compensation in New York?

Almost all workers are covered under Workers’ Compensation in New York. If you provide work or services for an employer, and you are not an independent contractor, you will likely be eligible for Workers’ Compensation Insurance. 

The following are categories of employees that are eligible for Workers’ Comp coverage:

• Full-time and part-time employees
• Apprenticeships and internships
• Volunteers of for-profit organizations
• Undocumented workers
• Domestic workers employed for 40 or more hours per week by the same employer
• Farm workers
• Minors

The following are categories of employees that are generally excluded from Workers’ Comp coverage:

• Independent contractors
• Unpaid volunteers of non-profit organizations
• Casual or occasional workers
• Sole proprietors, partners, and certain one/two person corporate officers

What Workers’ Compensation benefits do employees receive?

Under Workers’ Compensation in New York, employers are required to provide the following benefits to employees who are injured in the course of employment:

Medical Benefits

• Employers are required to cover expenses for medical, dental, surgial, optometric, or other treatment. They are also required to pay for nurse and hospital services, medicine, optometric services, crutches, eyeglasses, false teeth, artificial eyes, orthotics, prosthetic devices, and functional assistive and adaptive devices and apparatus necessary for recovery. 
• In order to receive medical benefits, the employee must use a health care provider that is authorized by the WCB, except in an emergency situation. The WCB maintains a list of authorized facilities, physicians, and treatment guidelines. 

Temporary Total Disability Benefits

• If an employee is unable to earn wages due to an injury, he or she is eligible to receive Temporary Total Disability (TTD) benefits while recovering, which provides 66 and two-thirds percent of a worker’s average weekly wage pre-injury. 
• The WCB establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred between July 1, 2020 and June 30, 2021, the maximum TTD benefit was $966.78 per week. The minimum benefit amount was $150 per week or the injured employee’s average weekly wage if it is less than $150.

Temporary Partial Disability Benefits

• An injured employee may be able to return to work while recovering in a partial or limited capacity. If the employee works fewer hours or receives lower wages during this time, he or she may be eligible for Temporary Partial Disability (TPD) benefits. TPD benefits provide two-thirds of the difference between a worker’s pre- and post-injury average weekly wage.
• The WCB establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred between July 1, 2020 and June 30, 2021, the maximum TPD benefit was $966.78 per week. The minimum benefit amount was $150 per week or the injured employee’s average weekly wage if it is less than $150.

Permanent Partial Disability Benefits

• If an injured employee recovers from an injury but has permanently lost some wage-earning capacity, he or she may be eligible for Permanent Partial Disability (PPD) benefits.
• The total amount that is paid out for PPD benefits depends on a number of factors, including the severity of the disability and whether the loss is a “schedule loss of use” or “non-schedule.”
• A schedule loss involves the loss of use of an upper extremity (shoulder, arm, hand, wrist, finger), lower extremity (hip, leg, knee, ankle, foot, toe), or eyesight or hearing. Benefits are paid out for a certain number of weeks depending on the body part and severity of the disability, according to the WCL schedule.
• Non-schedule losses involve body parts that aren’t classified as a “schedule loss of use,” such as the spine, pelvis, lungs, heart, or brain. Benefit amounts are based on the employee’s permanent loss of earning capacity percentage.
• The WCB establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred between July 1, 2020 and June 30, 2021, the maximum PPD benefit was $966.78 per week. The minimum benefit amount was $150 per week or the injured employee’s average weekly wage if it is less than $150.

Permanent Total Disability Benefits

• If an injured employee develops a permanent total disability precluding the possibility of earning any wages, he or she may be eligible for Permanent Total Disability (PTD) benefits. 
• Permanent total disability is presumed when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. 
• PTD benefits provide 66 and two-thirds percent of a worker’s average weekly wage pre-injury, payable as long as the employee remains permanently and totally disabled and is unable to earn wages.
• The WCB establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred between July 1, 2020 and June 30, 2021, the maximum PTD benefit was $966.78 per week. The minimum benefit amount was $150 per week or the injured employee’s average weekly wage if it is less than $150.
• There are no limits to the number of weeks that PTD benefits are payable.

Disfigurement Benefits

• Serious and permanent disfigurement to the face, head, or neck may entitle the worker to compensation up to a maximum of $20,000, depending upon the date of the accident.

Death Benefits

• Employers are required to pay funeral expenses up to $12,500 in Metropolitan New York counties and $10,500 in all other counties.
• A worker’s surviving dependents may be eligible to receive two-thirds of the deceased employee’s average weekly wages, up to the maximum set by the WCB. For accidents that occurred between July 1, 2020 and June 30, 2021, the maximum benefit was $966.78 per week. The minimum benefit amount was $150 per week or the injured employee’s average weekly wage if it is less than $150.
• If the employee had no surviving dependents, the surviving parents or the estate of the deceased employee may be entitled to payment of a sum of $50,000. 

What are the penalties for breaking New York Workers’ Compensation laws?

Failure to adhere to the Workers’ Compensation laws set out by the WCB can result in significant fines and even imprisonment. In order to avoid any costly penalties, it’s important to consult the WCB or your insurer to ensure you are in compliance. Below are the major ways in which companies can be penalized:

Failure to Secure Coverage

• Failure to secure Workers’ Compensation Insurance for five or less employees within a 12-month period will result in a misdemeanor charge, punishable by a fine of between $1,000 and $5,000.
• Failure to secure Workers’ Compensation Insurance for more than five employees within a 12-month period will result in a class E felony charge, punishable by a fine of between $5,000 and $50,000, imprisonment for up to four years, or both.
• Subsequent failures to secure Workers’ Compensation Insurance will result in a class D felony charge, punishable by a fine of between $10,000 and $50,000, imprisonment for up to seven years, or both. 
• The WCB may also impose a civil fine of $2,000 for each 10-day period of non-compliance. The total fined amount cannot exceed two times the cost of compensation the employer would have paid for its employees during the period of non-compliance.

Misrepresentation

• If an employer attempts to intentionally and materially understate or conceal payroll, conceal employees duties to avoid proper classification, or conceal any other information needed to calculate premiums, they may be charged a civil fine of $2,000 for every 10-day period of non-compliance or two times the cost of compensation.
• An additional criminal fine of between $1,000 and $50,000 may also be levied.

Failure to Maintain Accurate Payroll Records

• Employers must keep accurate records of their employees, employee classifications, employee accidents, and wages paid for a period of four years. 
• If an employer fails to keep these records, furnish these records as required, or falsifies any records, they may be charged with a misdemeanor, punishable by a fine of between $5,000 and $10,000.
• Any employer that has previously been subject to this penalty within the last ten years will be charged with a class E felony, punishable by a fine of between $10,000 and $25,000, imprisonment for up to four years, or both.
• The WCB may also impose a civil fine of $1,000 for each 10-day period of non-compliance. The total fined amount cannot exceed two times the cost of compensation the employer would have paid for its employees during the period of non-compliance.

How much does Workers’ Compensation Insurance cost in New York?

According to the National Academy of Social Insurance Workers’ Compensation Report (October 2019), the average employer cost for Workers’ Compensation in New York was $1.46 per $100 of covered wages. This figure is estimated across all insurers and all industries, so the cost to your particular business may vary.

How does the Workers’ Compensation claims process work in New York?

The claims process in New York begins with the employee. If an employee suffers a work-related injury or illness, he or she must report the condition to the employer in writing within 30 days of the injury or accident. Any delay in reporting may result in delays in the claims process or denial of the claim.

The employer can then investigate the incident and must file a report with the WCB and their insurer within 10 days of the accident. The insurer then has 10 days after receiving the report or 18 days from the date of disability or 10 days after the employer has knowledge of the accident, whichever is greater, to deny or approve a claim.

If the claim is approved, the insurer must begin paying benefits to the injured employee within 10 days of receiving the employer report of the accident, 18 days after the date of disability, or 10 days after the employer has knowledge of the accident.

If the claim is disputed, a hearing will be held with a WCL judge who will make a decision on the claim.

New York Workers’ Compensation Insurance Resources

For more information on New York Workers’ Compensation laws and requirements, please visit the following resources:

• New York Workers’ Compensation Board (WCB)
• New York WCB Employers’ Handbook