Denied Workers Comp Benefits? Settlement is still possible

A recent court opinion from the Appellate Division, First Department found in favor of an injured worker who previously had his workers’ compensation benefits cut off. (Amacio v. State of New York, 2015 NY Slip Op 06298). The worker, Mr. Amacio, sustained injuries during his employment in 1998, which required spinal fusion surgery. He began receiving workers’ compensation benefits in 1999 from the insurance carrier of his employer. Because the injury occurred on property owned by the State of New York, he also filed a third-party tort action against the state.

The state settled its action with Mr. Amacio in 2000, but the employer’s insurance carrier was not present and did not agree to the settlement. In April 2008, after the insurance carrier went bankrupt, the New York State Liquidation Bureau suspended Mr. Amacio’s benefits. The suspension was affirmed in 2011.

In 2012, Mr. Amacio sought to approve the original settlement with the State of New York nunc pro tunc (retroactive approval of the settlement). The claim was denied on the grounds that improper procedure was followed. On July 28, 2015, this decision was reversed and Mr. Amacio’s petition to approve the settlement was allowed.

Under New York law, settlements previously agreed upon, even if approval is being sought over three months after the intended settlement date, may still be approved if the petitioner can show:

  • the settlement amount is reasonable;
  • the delay in applying for approval was not the petitioner’s fault; and
  • the insurance carrier suffered no harm due to the delay.


Have You Been Denied Benefits?

What does this mean for you and your loved ones? Workers’ compensation cases can be stressful for the injured and their families. The injured person may be out of work for several months with the decision as to whether or not they will receive benefits from their employer’s insurance carrier hanging over their heads. Not only does the injured have to worry about paying for his or her medical treatment, he or she must also worry about replacing the income that would have been earned during the time medical treatments are being sought. There can also be complicated processes and loopholes in filing these claims with your employer’s insurance carrier.

If you have been injured on the job or have been denied workers’ compensation benefits under any circumstances, you may have rights and additional recourse against your employer or their insurance carrier. It is important to consult with an experienced workers’ compensation attorney to know your rights and to be able to take action to get the benefits to which you are entitled.

The lawyers at Napoli Shkolnik PLLC can assist you through each stage of the process, whether you have not yet filed or a claim or whether you have already been denied benefits. Call (212) 397-1000 today to schedule a free consultation with a knowledgeable workers’ compensation attorney.