Key Takeaways
- New York workers' compensation is mandatory for most employers, including those with only one employee
- The New York State Insurance Fund (NYSIF) is the state-run workers' comp insurer
- Employers can obtain coverage from private insurers, NYSIF, or self-insure with approval
- Workers' Compensation Board (WCB) administers the system, not DFS
- Uninsured employers face severe penalties including criminal prosecution
New York Workers' Compensation Insurance
New York has one of the most comprehensive workers' compensation systems in the nation.
Mandatory Coverage
New York requires workers' compensation for most employers:
Who Must Be Covered
| Worker Type | Coverage Required |
|---|---|
| Full-time employees | Yes |
| Part-time employees | Yes |
| Seasonal workers | Yes |
| Domestic workers (40+ hours/week) | Yes |
| Farm laborers | Yes |
| Most corporate officers | Yes |
| Independent contractors | Generally no |
Limited Exceptions
- Sole proprietors (optional for themselves)
- Partners (optional for themselves)
- Some ministers and clergy
- Certain volunteers
Obtaining Coverage
New York employers have three options for workers' comp coverage:
Coverage Options
| Option | Description |
|---|---|
| Private Insurance | Purchase from admitted insurer |
| New York State Insurance Fund (NYSIF) | State-run insurer |
| Self-Insurance | WCB approval required |
New York State Insurance Fund (NYSIF)
NYSIF is:
- Largest workers' comp carrier in New York
- State agency operating as a competitive insurer
- Must accept all employers that apply
- Competes with private market
- Not a residual market - competes on rates
Self-Insurance Requirements
- Financial strength requirements
- Security deposit required
- WCB approval required
- Reporting requirements
- May use third-party administrator
Workers' Compensation Board (WCB)
The Workers' Compensation Board administers New York's workers' comp system:
WCB Functions
| Function | Description |
|---|---|
| Claims Administration | Processes claims, resolves disputes |
| Compliance | Ensures employer compliance |
| Rate Approval | Approves classification rates |
| Self-Insurance | Approves self-insurance programs |
| Medical Guidelines | Sets treatment guidelines |
Note: The Workers' Compensation Board, not DFS, administers workers' compensation in New York.
Benefits
New York workers' comp provides comprehensive benefits:
Benefit Types
| Benefit | Description |
|---|---|
| Medical Care | All reasonable medical treatment |
| Temporary Total Disability | 2/3 of average weekly wage (capped) |
| Temporary Partial Disability | 2/3 of wage difference |
| Permanent Partial Disability | Schedule or non-schedule |
| Permanent Total Disability | 2/3 of average weekly wage |
| Death Benefits | To dependents |
Waiting Period
- 7-day waiting period for disability benefits
- Waiting period waived if disability exceeds 14 days
- Medical benefits from day one
- No waiting period for medical care
Penalties for Non-Compliance
New York has severe penalties for uninsured employers:
| Penalty | Details |
|---|---|
| Civil Penalty | Up to $2,000 per 10-day period |
| Criminal Prosecution | Misdemeanor or felony |
| Stop Work Order | Can shut down business |
| Personal Liability | Employer personally liable for claims |
| Double Damages | Employee can sue and recover double |
Exam Tip: New York takes workers' comp compliance very seriously. Know the penalties and coverage requirements.
What is the New York State Insurance Fund (NYSIF)?
Which agency administers workers' compensation in New York?
What is the waiting period for workers' compensation disability benefits in New York?