Help Wanted: How to prove a workers' comp claim

DEAR CARRIE: My fiance was working a night shift when he became ill. Paramedics took him to the hospital. I think he had a heart attack because he later had triple bypass surgery. Is he entitled to any help from workers' comp since the incident happened at work? And, if so, whom would I call? -- Entitled to Comp?

DEAR ENTITLED: He could be entitled to workers' compensation benefits. But a physician has to determine if the illness was job-related, said Joe Cavalcante, a spokesman for the state Workers' Compensation Board.

"If the heart trouble discussed is due to a worker's job, then the employee may be eligible for medical and wage benefits," he said.

Besides getting a doctor's determination, your fiance should advise his employer of the incident in writing within 30 days of the illness, Cavalcante said. And he should file form C-3 with the board. 

DEAR CARRIE: My 48-year-old daughter, who is a divorced mother of a 16-year-old, worked more than 20 years in a job requiring her to lift heavy objects, with frequent trips up and down stairs. She quit her job at the end of January because she couldn't bear the pain in her knees and back and she collected short-term disability. The company didn't have long-term benefits.

The doctors diagnosed her with arthritic knees and five slipped discs in her back, which they attributed in part to years of heavy lifting. In order to support herself and her child, she cashed in her 401k.

A lawyer is helping her apply for Social Security disability benefits but that could take a while and many cases are declined. In the meantime, she heard that she could not apply for workers' comp because she wasn't hurt on a specific date. Are there any other options? -- Worried Mom

DEAR WORRIED: She shouldn't rule out workers' comp benefits just yet, even though her medical condition developed over time.

"Degenerative conditions occur over a period of time," said Cavalcante, the board spokesman. "So if there is no single incident that caused this injury, then not having a single accident date does not prevent a worker from filing a claim," he said.

More specifically she could have what is known as an occupational disease, which are diseases, or conditions, that are "a common hazard" to employees performing the same kind of work, and develop while the workers are performing that work, he said.

"So if your daughter worked in an occupation where all employees in the same kind of employment also developed knee and back trouble, she may have an occupational disease," he said. "Occupational diseases, like degenerative accidents, do not happen on a specific date. Rather, the Workers' Compensation Board finds a date of disablement or a date of accident."

But she, too, needs confirmation from a doctor. "Only a medical provider can make that diagnosis and find that causal relationship," he said.

And she should inform her former employer in writing of her injuries and file workers' comp form C-3.

The bottom line is that she could receive benefits. "A person injured by duties performed at work may be eligible for workers' compensation benefits," Cavalcante said. "The benefits include medical care for that injury and a benefit for lost wages."

Click here for more on filing workers' compensation claims, at www.wcb.state.ny.us/content/main/onthejob/howto.jsp

Or call the Hauppauge district office at 866-681-5354 or the Hempstead office at 866-805-3630.