Process Stage 4 of 12

Receiving NY Workers' Comp Benefits — What to Watch For.

Indemnity checks are coming in. The case is open, the carrier is paying, treatment is ongoing. This is the longest stage in most cases, and the one where the most quiet damage gets done — a low Average Weekly Wage that gets locked in, a stale medical record that gives the carrier an excuse to suspend, a missed IME, or a settlement offer that comes in early at a number that ignores the long arc of the claim. The work here isn't reactive — it's protective.

Checks aren't a finish line. They're the period when the long-term value of the case is being set.

What's happening

You are receiving Temporary Total Disability (TTD) or Temporary Partial Disability (TPD) indemnity benefits. Your treating physician is filing C-4 reports. The carrier is monitoring — through medical records, periodic IMEs, sometimes surveillance. The case is moving toward either return to work, classification (permanency), or settlement. Quietly in the background, the dollar value of the case is being set: by the AWW the carrier accepted, by the medical record being built, by what your treating physician documents about disability and prognosis.

What comes next

  1. Verify your weekly rate. Run the Weekly Rate Calculator. Compare it to what you're actually receiving. If you're not at the rate you should be, the AWW underlying the calculation is probably wrong — fixable, but the longer it sits, the harder.
  2. Maintain current C-4s. Indemnity is medically driven. A C-4 older than ~90 days can be used as a basis to suspend benefits. Make sure your treating physician is filing on schedule.
  3. Attend any IME — and prepare for it. Refusing an IME typically suspends benefits. Attending an unprepared IME often produces a report that ends benefits anyway. Know what to expect.
  4. Be careful what you do that could be recorded. Social media, public outings, physical activity — anything visually inconsistent with your reported disability can end up in a surveillance video the carrier shows at hearing.
  5. Don't engage in settlement discussions unrepresented. Early offers, particularly within the first year, are almost always low. The math on a Section 32 settlement is permanent and unforgiving.

Common pitfalls at this stage

  • Accepting a first-pass AWW that's too low. Carrier AWWs routinely omit overtime, premium pay, holiday pay, mutual swaps, run-around for transit workers, tips, regular bonuses. If your AWW looks low, it almost certainly is.
  • Letting medical lapse. Even brief gaps in C-4 filings can trigger suspension. Treat the schedule of follow-ups as part of the case management.
  • Treating the IME like your treating doctor. The IME is the carrier's expert, not yours. The IME report is not a treatment record; it's an evaluation prepared for the carrier.
  • Engaging in settlement talks without representation. Early Section 32 offers are typically a fraction of what mature cases settle for. Once you sign, you're done.
  • Returning to work prematurely without medical clearance. A return-to-work attempt without a formal clearance can be used to argue you're no longer disabled, ending indemnity even if you can't sustain the work.

Tools, FAQs, and pages relevant to this stage

When to call now

If the carrier files any SROI suggesting suspension, if you receive notice of an IME, if a Section 32 offer arrives, if your rate looks wrong, or if your treating physician mentions MMI or classification — call now.

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Attorney Advertising — Educational Use Only. This page provides general information about New York workers' compensation. It is not legal advice and does not create an attorney-client relationship. Every case turns on its facts. For analysis of your matter, contact Levi directly.

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