Protecting Your Rights After a Workplace Injury in NYC
A serious work injury turns your world upside down, especially when the insurance company:
- Denies your claim
- Cuts your pay unexpectedly
- Refuses to authorize your surgery
When you try to question the insurance adjuster, they might give you the runaround or ignore your calls completely. It seems unprofessional—and it is. It feels wrong—and it is. But what can you do? You feel stuck and overwhelmed.
When the whole system feels against you, it helps to have a strong advocate on your side. A workers’ compensation attorney can fight back when the insurance company treats you unfairly.
So if you’re out of work because of a rotator cuff tear, carpal tunnel syndrome, ACL tear, broken wrist, ankle fracture, concussion, or another serious condition, you don’t have to deal with the workers’ compensation system alone.
Speak with a Manhattan workers’ compensation lawyer about your claim today. A free case review can help you understand your rights to lost-wage benefits, medical treatment, and additional compensation for permanent impairment.
Book a Free Case Evaluation Phone Call or dial us 24/7 to request one. We’ll fight for your compensation while you focus on your recovery.
Challenging a Denied Workers’ Compensation Claim in Manhattan
If your employer or the insurance company disputes whether your injury is work-related, they might deny your claim.
Especially if you’re out of work, a denied claim is a serious hardship because you will not be getting paid through workers’ compensation.
Here are some of the most common questions injured workers in Manhattan have after their claim is denied along with helpful answers that generally explain how denials can be successfully challenged.
Why do insurance companies deny workers’ compensation claims in New York City?
Insurance companies deny claims when they believe the injury or condition is unrelated to your job. Denials are especially common in occupational disease or repetitive motion injuries that develop over a longer stretch of time such as carpal tunnel syndrome.
Example: A construction worker develops severe carpal tunnel syndrome after years of repetitive work gripping tools with strong vibrations. His doctor says his job contributed to the condition, but the carrier denies the claim because they believe something else caused it.
Do injured workers have to accept the insurance company’s denial?
No. A carrier’s denial is not the final word. A disputed claim can be litigated before the New York Workers’ Compensation Board, which is something a lawyer can help you with.
Example: A cleaner working in a Midtown Manhattan building suffers an ankle fracture. The carrier disputes how the accident happened and denies the claim, at which point the case is brought before a Workers’ Compensation Law Judge to decide if the accident happened at work.
What does litigation before the Workers’ Compensation Board look like on a denied claim?
Generally it will consist of the Board holding hearings and considering medical records, testimony, reports, and other evidence to determine whether the claim should be established as a work-related injury.
Example: A warehouse employee working in Hudson Yards tears his rotator cuff lifting heavy boxes. The carrier says it was a pre-existing condition. His attorney can present medical and factual evidence at a hearing connecting the injury to his work.
Can a lawyer help overturn a denied claim?
Yes. A workers’ compensation lawyer can help gather medical records, conduct an investigation, depose doctors, and cross-examine employer witnesses at a hearing to convince a judge that the carrier’s denial was wrong and that the claim should be established as a work-related injury.
Example: An ER nurse at a local hospital in Manhattan has a note from her doctor clearly stating her shoulder tear is related to her work, but the insurance adjuster denies the claim anyway. The nurse’s attorney can present that proof to the workers’ compensation judge and challenge any contrary evidence submitted by the carrier.
Can NYC injured workers receive benefits going back to the date of disability if a denial is overturned?
Potentially yes—and it’s quite common that this happens. If the Board establishes the claim and finds compensable periods of disability, benefits may be awarded dating back to the initial date of disability.
Example: A home health aide is denied after a serious knee injury caring for an elderly patient on the Upper West Side and misses several months of work. If the claim is later established, the Board can address the benefits owed for the compensable period she was unable to work.
Pursuing Full Compensation for Lost Wages After a Work Accident in Manhattan
Lost-wage benefits are critical when an injured worker has rent, childcare costs, and other bills. After all, your obligations to pay for those sorts of things don’t stop just because you get hurt at work.
Making sure you get paid the full amount you’re owed is one of the most important jobs of a workers’ compensation lawyer. Here is a helpful guide that generally explains lost wages for a job-related accident in New York, NY.
Can your average weekly wage affect how much you receive?
Yes. Your average weekly wage (“AWW”) is an important part of determining how much you’ll get paid while you’re out of work. The Board generally looks at your gross earnings during the 52 weeks before your injury. If you’ve been at the job for less than a year, then your AWW is determined by using a similar worker.
Example: A package delivery driver who got hurt at work after just two months on the job will have his AWW calculated by looking at the last 52 weeks’ worth of earnings for a similar driver.
Who needs to submit proof of an injured worker’s wages to calculate the AWW?
This is the responsibility of your employer and their insurance carrier. Your employer fills out a “C-240” form, which must then be filed with the NYS Workers’ Comp Board by the insurance carrier. This form details your wage information that will then be used to calculate your AWW.
Example: A restaurant cook in Times Square earned different amounts during busy and slow weeks. The C-240 can help show the actual earnings used to calculate his AWW.
When can injured workers receive temporary total disability benefits?
In New York, temporary total disability (TTD) benefits are a form of lost wage compensation that applies when the medical evidence says you’re 100% disabled temporarily.
TTD benefits are 2/3rds of your AWW, subject to a state maximum rate that changes on July 1st each year. As of 7/1/26, the max TT rate in New York is $1,281.50.
Example: An auto mechanic in Washington Heights who is recovering from shoulder surgery is taken completely out of work at 100% TTD. He will get 2/3rds of his average weekly wage as his TTD payment.
When can injured workers receive temporary partial disability benefits?
Temporary partial disability (TPD) benefits apply when an injured worker is out of work but the medical evidence says they are less than 100% disabled. The amount they’ll get paid on TPD will depend on the exact percentage of disability.
Example: A retail employee with a torn meniscus is making progress with post-operative physical therapy, and after a few months the doctor changes her degree of disability from 100% TTD to 50% TPD. However, her employer cannot accommodate light duty, so she remains out of work. Accordingly, her TPD payments will be half of what her TTD payments were.
Can an insurance company use an IME to try to reduce your benefits?
Yes—but there are ways to fight this. An independent medical exam (“IME”) is set up by the insurance adjuster for you to see a doctor of their choice for a one-time appointment. If that doctor says you’re less disabled than your own doctor says, they may try to use it to reduce or suspend your benefits. An attorney can help challenge this by requesting a hearing and then deposing the IME doctor.
Example: A parking lot attendant’s doctor says he is 100% disabled after an ankle fracture. An IME doctor says he is only 25% disabled. The insurance company might reduce payments to the 25% temporary partial disability rate unless there is a previous decision on record from the judge directing payments at a higher rate. If the worker’s lawyer can challenge the IME doctor’s findings successfully at a deposition, a judge might award compensation at a higher rate despite the IME.
Obtaining a Schedule Loss of Use (SLU) Award in NYC
An SLU can provide a significant additional workers’ compensation benefit when a work injury leaves permanent loss of function for certain body parts, especially if there’s been a surgery.
What is a Schedule Loss of Use award?
An SLU is a cash benefit for permanent impairment such as lost range of motion of an eligible body part caused by a work injury. A workers’ compensation judge determines the SLU rating based on the available medical evidence and the guidelines set by law.
Which body parts can qualify for an SLU?
SLU awards can apply to the shoulder, arm, elbow, hand, wrist, fingers, thumb, hip, leg, knee, ankle, foot, toes, eyes, and ears.
Is an SLU common in NYC if there’s a diagnosed tear or surgery to repair it?
Yes. In practice, it’s very common for injured workers to get an SLU award when they have a tear surgically repaired. Even tears that don’t require surgery still commonly result in SLU awards.
In fact, in plenty of cases, sprains and strains have resulted in SLUs too, which is why injured workers’ who’ve injured an SLU-eligible body part may wish to consult with an attorney to learn more about how they can pursue an SLU award.
Example: A janitor at a middle school in East Harlem undergoes surgery for a torn meniscus. A year after the surgery, his doctor finds permanent impairment resulting in an SLU.
Can the insurance company dispute the SLU percentage?
Yes. Claims adjusters often get an IME when they believe your doctor’s SLU percentage is too high. If there ends up being disagreement between the IME and your doctor, the issue of the correct SLU percentage will need to be litigated before the Board.
Example: Your doctor finds a 30% loss of use of your shoulder. The carrier’s doctor says 10%. That difference can have a major effect on the value of the award.
How might an SLU award work in practice?
The value depends on the body part, percentage of loss, and TTD rate. Once the award is calculated, the amount of the prior temporary disability payments is subtracted from the SLU award’s total.
Example: An EMT undergoes shoulder surgery after suffering a rotator cuff tear caused by lifting an injured pedestrian onto a stretcher in East Harlem. Based on their AWW of $1,800 their TTD rate is $1,200.
If both their doctor and the IME say they have a 25% SLU, that equates to 78 weeks. You then multiple 78 by the TTD rate of $1,200, at which point you get an SLU award of $93,600 less the amount of temporary disability already paid on the case.
Ready to Speak With a Manhattan Workers’ Comp Attorney? Call Today for a Free Consultation.
If you’re waiting for surgery to be approved, dealing with an insurance adjuster who isn’t treating you fairly, or fighting a denied claim, you might feel overwhelmed and not sure what to do next.
A New York workers’ compensation lawyer can help you understand your rights, move your claim forward, and relentlessly pursue the full compensation you deserve.
So whether you’re a nurse or healthcare worker, security guard, bus driver, construction worker, or anything else, if you’re not sure where to turn after a serious work accident in Manhattan, contact the Law Office of Michael J. McConnell today for a free case evaluation.
Simply give us a call at (914) 810-0510 or sign up for one below. Let’s begin building a gameplan to help you move forward today.
Disclaimer: For informational purposes only. The contents of this page should not be considered legal advice. If you need legal advice, contact a qualified attorney in your jurisdiction immediately for a confidential consultation centered on the unique facts of your particular situation. Prior results don’t guarantee future outcomes.
This page was last updated on August 20th, 2026.