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If you have suffered an injury following a car accident in New York and can’t work, there are ways in which you can get reimbursed for at least part of your salary and possible even all of it, depending on certain factors. To understand how lost wage reimbursement works in New York, it is important to give a little background on New York’s system of car insurance.
New York is a no-fault state. What that means is that every automobile policy is required to provide payment of medical benefits, lost wages and certain out of pocket expenses regardless of who was at fault for the car accident. The insurance policy that is responsible for paying those expenses is the policy that covers the vehicle that you are occupying at the time of your accident, regardless of fault. However, there are some limits on what your no-fault provider will pay for.
First, the minimum amount of no-fault insurance a carrier is allowed to sell in a New York policy is $50,000. That means once your combined medical bills, lost wages and out of pocket expenses exceed $50,000, your carrier will stop paying those expenses. However, it is possible to purchase additional no-fault benefits. But those benefits have to be in place prior to your accident in order to apply.
The second limitation of no-fault to consider when trying to calculate how much you can get reimbursed for your lost time from work is the no-fault wage cap of $2,000 a month. No-fault will only pay 80% of your salary up to $2,000 a month. This means that if you earn in excess of $2,000 a month, you will not be able to obtain full compensation for your lost time from work from your no-fault carrier. It is also possible to purchase additional lost wage protection that will pay you in excess of $2,000 a month. But again, those benefits must have been purchased prior to your accident.
In order to qualify to receive lost wages from your no-fault carrier, you will need to meet certain requirements. Most importantly, you must file a no-fault application with your carrier within 30 days of your accident. You will also need to provide a disability letter from your treating physician and update it from time to time, usually every thirty days. Your employer will also have to complete a wage verification form for your insurance carrier. Once all three requirements are satisfied you will start receiving no-fault lost wages.
Your carrier does have the right to request that you attend a physical exam from time to time to determine if you are able to return to work. This exam is known as an Independent Medical Exam (IME). Basically, your insurance carrier will set up an examination with a medical professional in the area that you are receiving treatment. For example, if you are treating with an orthopedic doctor in Suffolk County, NY, your carrier will hire an orthopedic doctor in that county to examine you. If that doctor determines that you are healed, they will terminate your no-fault benefits and your lost wages will cease even if your doctor disagrees.
The IME doctor is not an employee of the insurance carrier, they are hired as an “independent contractor.” This implies an air of impartiality. However, that is often not the case since the insurance carrier will tend to use the same doctors hundreds of times a year. If you feel that your no-fault carrier has unfairly denied your no-fault claim for lost wages as a result of an IME, you have the right to appeal the denial through a no-fault arbitration. Unfortunately, this is a complicated process and best handled by an attorney.
For those people that earn in excess of what no-fault will pay, there are other ways to get reimbursed for your lost wages. If you are not at fault for your accident, you may be entitled to pursue a bodily injury claim against the at-fault party’s insurance carrier. If successful, you will be entitled to receive whatever you have not been paid by no-fault for your lost wages until you reach 100% compensation.
Further, if you have a private disability policy, you may be eligible to receive compensation from that policy. No-fault will allow you to stack your policies, meaning if your policy pays you only partially, no-fault will kick in up to $2,000 more a month until you reach 100% of your salary.
Finally, dealing with lost wages can be tricky due to all of the red tape created by insurance companies. If you find yourself in over your head, it’s never a bad idea to seek help from a professional. Personal injury attorneys will usually offer a free consultation to discuss any issues that you have.
Steven Palermo is the managing partner for Palermo Law, Long Island’s Personal Injury Law Firm. He has been helping people receive compensation for their injuries for over 21 years. He focuses on cases involving car accidents, truck accidents, construction accidents and slip and fall injuries.
His book The Ultimate Guide to Handling New York Car Accident Claims details the ins and outs of a car accident claim in a simple, easy-to-read manner.