By: Michael J. McConnell – Westchester County workers’ compensation lawyer serving Yonkers, White Plains, Mount Vernon, New Rochelle, Port Chester, Mamaroneck, Rye, Ossining, Valhalla, Elmsford, Tarrytown, Eastchester, and more.
If you got hurt at work in Yonkers or anywhere else in New York, you could be eligible for workers’ compensation benefits, including necessary medical treatment at zero cost to you.
In this article, I will explain how New York workers’ compensation handles the payment of medical bills for work-related injuries.
As always, it is recommended that you seek immediate medical treatment if you are injured, and you may wish to consult with a New York workers’ compensation lawyer about the particular facts of your case.
The Law Office of Michael J. McConnell offers free consultations for injured workers in Yonkers, White Plains, Mount Vernon, New Rochelle, and the rest of Westchester County as well as New York State. Contact the office today for your free consultation.
The High Cost of Medical Bills
Medical bills can be expensive – especially for work-related injuries. Common work-related injuries in Yonkers like rotator cuff tears, meniscal tears, fractures, and carpal tunnel syndrome can often require surgery and a significant amount of post-operative treatment.
The costs in cases that require surgery are often a lot higher than one might expect. Surgery and its related costs for a workers’ compensation injury can range between a few thousand dollars to well over one hundred thousand dollars in just a single year. And beyond the year when the surgery occurred, there might be potential for years of further treatment and perhaps additional surgeries.
Even injuries that do not require surgery can still result in very high costs. Things like x-rays, MRIs, CT scans, physical therapy, chiropractic treatment, and durable medical equipment (braces, boots, etc.) can add up to tens of thousands of dollars.
Just thinking about the costs of medical treatment can feel overwhelming, but for injured workers in New York there is some very good news.
Necessary Medical Treatment is Covered by Workers’ Compensation in New York at Zero Cost to the Injured Worker
If you have been injured at work in Yonkers or elsewhere in New York, the good news is that you are not responsible for the medical expenses related to your injury so long as you have a valid claim that has been established by the New York State Workers’ Compensation Board.
In other words, there should be no copays or out-of-pocket expenses for your injury on an established claim. The medical bills should be sent by your doctor directly to the insurance carrier responsible for managing your workers’ compensation case. If your employer is “self insured” then the bill should go directly to them.
If, for example, there a dispute about the amount of payment or the appropriateness of the treatment, that is between the insurer and the doctor, which means nobody should be chasing you down for payment of the bill. The New York State Workers’ Compensation Board will resolve any disputes over medical bills between the insurer and the doctor.
Additionally, there is no pre-determined or statutory end date for your medical treatment. In New York, you are entitled to lifetime medical treatment related to your injury.
What Types of Medical Treatment Does Workers’ Compensation Cover if I Got Hurt at Work in Yonkers?
The types of treatment that can be covered under New York workers’ compensation include but are not limited to the following:
- Doctors Visits (e.g., orthopedic, chiropractic, pain management, podiatry, neurologist, hand specialist, etc.)
- Physical Therapy & Occupational Therapy
- Surgery
- Prescription Medication
- Diagnostic Tests (MRIs, X-Rays, CT scans, etc.)
- Injections
- Acupuncture
- Licensed Clinical Social Worker (LCSW)
- Dental
- Assistive Devices
- Durable Medical Equipment (DME)
Generally speaking, you can treat with the doctor, medical practitioner, or facility of your choice so long as they are authorized by the Board to treat injured workers. Of course, in a medical emergency it is okay to see a medical provider not authorized by the Board, so if you are injured and need immediate medical treatment you do not need to double check with the provider (e.g., hospital, emergency room, etc.) to figure out whether they are authorized by the Board.
If my medical treatment is supposed to be covered on my workers’ compensation claim, why does my doctor need authorization from the insurance company? And why won’t the insurance company approve my medical treatment?
While medical expenses for established claims are covered at no cost to the injured worker, there are rules in New York about what types of treatment can be done on your workers’ compensation claim.
Certain injuries, for example, require doctors to follow the New York State Medical Treatment Guidelines (NYS MTGs). While the MTGs do allow plenty of treatment without needing the insurance company’s authorization, there are certain types of treatment that do require prior approval. In those situations, your doctor needs to make a formal request for authorization and explain why the treatment should be approved.
If the insurance company denies an authorization for treatment, the doctor can request further review and the issue can even be litigated before the New York State Workers’ Compensation Board.
The ins and outs of the MTGs can get a bit complicated, and further discussion about the MTGs would be a bit beyond the scope of this article, which is primarily focused on explaining how medical expenses are paid. Stay tuned for a future blog post where I will discuss the MTGs and related topics in further detail. You can also check out the Board’s website for more information on the MTGs if you would like to learn more about them.
Is there any scenario where I could be responsible for medical expenses for a work-related injury in New York?
As noted above, medical expenses related to an established claim should be covered by the workers’ compensation insurance carrier at no cost to you.
If, however, the insurance carrier denies your claim and the New York State Workers’ Compensation Board agrees with them that the denial is proper and thus disallows the claim, you could be responsible for medical expenses. Whether you will be responsible and for how much will depend on the unique facts of your case, including whether you have health insurance and what it covers.
In general, if your claim has been denied by the insurance carrier and/or your employer, it may be in your best interest to consider obtaining legal representation. A workers’ compensation lawyer can evaluate the particular facts of your case and fight back against the denial using any and all appropriate legal arguments. Many times, insurance companies deny claims improperly, and a successful challenge to the denial will result in the Board establishing the claim and ordering them to pay for your necessary medical treatment.
Conclusion: If You Got Hurt at Work in Yonkers, Medical Expenses Can Be Paid Through Workers’ Compensation for an Established Claim
To sum things up, the bottom line is that you should not have to pay a single penny for any medical expenses that are related to an established work-related injury. New York workers’ compensation covers necessary medical treatment for that injury for the rest of your life – there is no fixed end date that you have to worry about.
With that said, certain medical treatments may need prior approval by the insurance company and the doctor must follow the New York State Medical Treatment Guidelines (MTGs) for certain injuries.
The one caveat to the general rule that injured workers are not responsible for their medical bills is this: if the insurance company denies your claim and the Board agrees by disallowing your claim, that is a situation where you could potentially be responsible for payment of medical bills. Navigating a denial is complicated and the stakes can be high, which is why it is generally recommended to consult with a workers’ compensation lawyer if your claim has been denied.
If you were injured at work in Yonkers, please contact the Law Office of Michael J. McConnell right now for your free consultation.
Want to know more about Michael J. McConnell – Westchester County workers’ compensation lawyer?
Michael J. McConnell is a Westchester workers’ compensation lawyer devoted to fighting for the rights of injured workers in Yonkers and the rest of New York State. He is a graduate of nearby Pace Law School in White Plains and is a former New York City prosecutor, where he handled cases ranging from misdemeanor assaults to serious felonies like armed robberies and stabbings. Michael J. McConnell prides himself on having a no-nonsense approach to litigation and quite frankly everything else he does. He also has over five years of experience handling exclusively New York workers’ compensation claims for a major insurance carrier – a significant number of which were from the NYC area, including Yonkers and the rest of Westchester County.
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Page Last Updated: 5/19/25.