Why Workers’ Comp Isn’t Always Enough

Why Workers’ Comp isn’t always enough is a question many injured workers find themselves asking after an accident. While New York law requires almost every employer to carry Workers’ Compensation insurance, this coverage has serious limits. 

The system is designed to provide basic support. However, it often fails to account for chronic pain, emotional distress, or the inability to return to your job. is Workers’ Comp enough? Not always—especially when injuries result in long-term consequences that go beyond medical bills or lost wages.

These gaps become more severe for immigrant workers, who frequently face unsafe conditions and fear retaliation if they speak up. In industries like construction, legal protections exist, but social and structural barriers make them hard to claim.

If you’ve been injured on the job, don’t assume Workers’ Comp is your only option. Speaking with a legal professional could help you understand your full rights.

Workers’ Compensation Benefits

In New York, workers injured on the job may qualify for several types of Workers’ Compensation benefits. This system helps cover medical care and lost wages.

There are three main categories of benefits. Each one addresses different needs depending on the nature and severity of the injury. Understanding these benefits helps you protect your rights and plan your next steps after an accident in the workplace.

1. Health Care

Health Care is one of the most important rights under the Workers’ Comp system. If you suffer a work-related injury or illness, you are entitled to receive medical care without paying out of pocket.

These services include: 

• Medical
• Surgical
• Dental
• Eye care
• Prescription drugs
• Necessary medical devices

In emergencies, any provider may treat you. In non-emergencies, only doctors authorized by the Workers’ Compensation board can provide care.

2. Lost Wage Benefits

Lost wage benefits are available to workers who cannot perform their jobs due to a work-related injury or illness. If you miss more than seven consecutive days, you may qualify to receive a portion of your lost wages.

These payments also apply if your injury forces you to work fewer hours or accept a lower-paying job. The system considers your average weekly wage, including income from multiple jobs if applicable.

If your claim is approved, the insurance company must begin payments promptly:

• They have 18 days from the injury or 10 days from the employer’s notice—whichever is later. 
• If your disability lasts more than 14 days, benefits may be paid retroactively starting from your first missed day.

3. Survivor Benefits

Survivor benefits provide financial support to family members when a worker dies due to a job-related injury or illness. The surviving spouse, minor children, or other legal dependents may receive weekly payments. 

These are equal to two-thirds of the worker’s average weekly wage from the year before the accident. In addition to weekly income, the law allows reimbursement for funeral or memorial expenses.

Workers’ Comp Doesn’t Cover Everything

Remember, Workers’ Comp doesn’t cover everything—and it’s important for you to know where the limits are. While the system offers essential benefits, it doesn’t meet every need. Consider the following:

• Some treatments or tests need formal approval, which can delay access to care.
• If your claim is denied, benefits may be delayed until a judge hears your case.
• Weekly payments are subject to a maximum limit that may not match your actual needs.
• Survivor benefits do not increase based on the number of dependents.

Can you sue if Workers’ Comp isn’t enough? In certain cases, yes. An experienced lawyer can help determine your options beyond standard coverage.

Additional Compensation After Workers’ Comp

Additional compensation after Workers’ Comp may be available if your case meets certain conditions. These benefits go beyond standard workers’ compensation and can offer greater financial relief:

1. You may file a third-party claim if someone outside your employer caused your injury.
2. A Section 32 Waiver allows you to settle your case for a lump sum payment.
3. Supplemental benefits apply to some workers injured before 1979.
4. Social Security Disability Insurance may also help if you are permanently disabled.
5. Medicare Set-Asides protect future medical coverage when a settlement is involved.

Workers’ Comp Limits and What You Can Do

Workers’ Compensation provides essential support when you’re injured on the job. It helps cover medical care and replaces a portion of lost income. However, the process isn’t always simple. 

Even when benefits are granted, legal caps, medical disputes, and slow payments can limit their real value. For surviving families, financial relief may fall short of their long-term needs—especially in high-risk, low-wage jobs. These limits make recovery harder, both emotionally and financially.

Why Workers’ Comp isn’t always enough is not just a question—it’s a reality for many. If you're facing challenges after a workplace injury, speak with a workplace injury lawyer.