A new accident made my comp injury worse: can workers' comp take back what it paid, or stop paying, in New York?

Attorney Answer

Benefits properly paid for the work injury generally are not taken back because a later accident happened. What can change is what comes next: the insurer can argue that the new accident, not the work injury, is now causing your disability, and the Workers' Compensation Board can divide the disability between the two on the medical evidence. The share that still comes from the work injury stays the comp carrier's. Money comes back to the carrier only in narrow cases: out of a recovery from someone responsible for the work injury, or where benefits were obtained by a knowing false statement.

Dividing the disability. The Board can apportion a disability between a work injury and a later accident outside work. In Matter of Cool v. TP Brake & Muffler, Inc., 305 A.D.2d 886 (3d Dep't 2003), the Appellate Division upheld the Board's finding that a back disability was 40 percent the result of the work accident and 60 percent the result of a demolition derby the claimant drove in two days later, based on medical opinion nobody contradicted. The medical evidence decides the split, which is why what your doctors say about each injury matters.

When comp can get money back. Two situations. First, if someone other than your employer caused the work injury and you recover from them, Workers' Compensation Law § 29(1) gives the carrier a lien on that recovery, after deducting the reasonable costs of getting it, including attorney's fees, to the extent of the compensation it paid. Second, Workers' Compensation Law § 114-a(1):

1. If for the purpose of obtaining compensation pursuant to section fifteen of this chapter, or for the purpose of influencing any determination regarding any such payment, a claimant knowingly makes a false statement or representation as to a material fact, such person shall be disqualified from receiving any compensation directly attributable to such false statement or representation.

That second rule is the reason to be completely open about the later accident.

If the later accident was a car crash. The injuries it caused are a claim under the insurance for that crash — no-fault benefits first, and possibly a claim against the driver at fault — separate from your comp case.

What you can do

1. Tell your doctors about both injuries, and ask them for an opinion on how much of your current condition comes from each.

2. If the carrier or the Board asks about the later accident, answer truthfully and completely.

3. Keep all records of both injuries, including any claim for the later accident.

4. If your benefits are reduced or stopped, talk to a New York workers' compensation lawyer before the hearing.

⏱ Time limits apply. If the carrier moves to reduce or stop benefits, the Board's notices carry their own dates. A claim arising from the later accident runs on its own clock.

A New York attorney can look at the specifics quickly, and most offer a short first conversation at no cost. A few minutes on your actual facts is worth more than any general guidance, this page included.