Payments of Workers' Compensation

NYSIF is required to begin payments within 18 days after the onset of disability. Subsequent compensation benefits are paid in bi-weekly intervals.  There is a statutory one-week waiting period (seven calendar days) for benefits. Compensation benefits are not payable when an injured workers' lost time is equal to or less than one week. If the injured worker loses between one week and two weeks from work, benefits are payable only for the lost time that exceeds seven days.

If the injured worker's lost time exceeds two weeks, benefits are payable from the date of disability. NYSIF confirms the accident and the disability with the employer by phone or field investigations and obtains written or oral confirmation from the attending physician.

Compensation rates are determined from earnings obtained from payroll records for the last 52 weeks prior to the date of accident. If this information is incomplete, the case manager establishes a temporary rate, subject to retroactive adjustment upon receipt of a completed C-240 "Employer's Statement of Wage Earnings Preceding Date of Accident." The injured employee is entitled to a compensation rate equal to two-thirds of the average weekly wage (AWW) for the 52-week period immediately prior to the date of accident, subject to prescribed maximums and degree of disability.

Why Compensation May Not Be Paid

• Lost time does not exceed the waiting period of seven calendar days;

• If lost time does not exceed 14 days, the first week is not payable;

• Lost time exceeds seven days, but

• NYSIF received no medical evidence of a causally-related disability beyond seven days;

• The employer is paying full wages;

• In death cases, NYSIF is waiting for evidence of dependency as an entitlement to benefits;

• NYSIF is disputing the claim on behalf of the policyholder.