Maytum Hall administration building on the Fredonia campus.

Workers' Compensation Frequently Asked Questions


· Q. How will my workers compensation benefits be calculated?
· A. 2/3 x average weekly wage x % of disability = weekly benefit. The weekly maximum total disability is up to 60% of the usual wage.

· Q. What will happen with my usual health insurance deduction?
· A. You will have two options available to you:

  1. Receive direct billing for the usual amount that was deducted from your paycheck. The state will continue to pay the balance.
  2. Pay nothing until you return to work. A maximum of $55 (in addition to your usual health insurance deduction) will be deducted per pay until the back amount is caught up.

· Q. What will happen to the automatic deductions from my paycheck; such as loan payments, and union dues?
· A. The employee is responsible for making payments for any such deductions during periods of leave without pay.

· Q. Will lost time be restored to me?
· A. Your first 5 days of absence are charged to sick time. You may be eligible to have this time restored to you only if your total lost time exceeds 14 calendar days.

· Q. Will I continue to accrue vacation and sick time while out on workers compensation leave?
· A. Yes.

· Q. Can I see a doctor or specialist of my choice?
· A. Yes, you may see the physician of your choice without the need for prior authorization.

· Q. When must prior authorization for medical care be obtained?
· A. When specialist consultations, surgical procedures, physiotherapeutic procedures, X-rays or special diagnostic laboratory tests cost more than $1,000.

· Q. Are prescription drugs and medications covered under the law?
· A. Yes.

· Q. Must an injured worker submit to a medical examination when requested to do so by the employer or insurance carrier?
· A. Yes. The employer or insurance carrier is entitled to have the worker examined by a qualified physician. Refusal to submit to an exam may affect the worker's claim.

· Q. What is the penalty for making a false claim?
· A. A person who willfully misrepresents the circumstances surrounding his or her case in order to obtain benefits is guilty of a felony.

· Q. Who is Fredonia’s insurance carrier for workers’ compensation?
· A. The NYSIF—New York State Insurance Fund, 225 Oak St., Buffalo, NY 14203