By Rosalind Asch-Hobeck

Coverage Issues Can Arise in Workers’ Compensation Claims

Most employers in New York and across the country are aware of their legal responsibility to carry workers’ compensation insurance. This coverage is meant to provide critical benefits to employees who are injured on the job, including medical treatment, wage replacement, and in some cases, permanent disability compensation. The system is designed to be “no-fault,” meaning that an injured worker does not need to prove negligence in order to receive benefits. But this safety net only functions when coverage is active and compliant with the law.

Unfortunately, not every employer maintains continuous, valid coverage. Coverage issues can arise for a number of reasons, some due to administrative oversight, and others due to deliberate misclassification or attempts to reduce costs. For example, a policy may lapse due to missed premium payments, or the employer may simply fail to renew the policy when it expires. In other instances, disputes may emerge over whether a worker is truly an employee or an independent contractor—an issue that can dramatically affect whether or not workers’ compensation benefits are available.

Industry Matters: Why Some Sectors Face Greater Risk

Certain industries are particularly susceptible to workers’ compensation coverage problems. Construction is one of the most frequently cited, due to its fragmented and layered employment structure. In a typical construction project, there may be a general contractor, several subcontractors, and a rotating cast of independent workers or day laborers. Each party might believe that another is responsible for coverage. This can lead to dangerous gaps, leaving workers unprotected despite being on the job at a high-risk site.

Similarly, gig economy jobs—such as rideshare driving, food delivery, or freelance manual labor—have rapidly grown in recent years. Employers in these industries often classify workers as independent contractors, who are typically not covered by workers’ compensation. However, courts and administrative bodies have increasingly scrutinized these classifications. If a worker performs duties that resemble those of an employee—such as adhering to a schedule, wearing a uniform, or being supervised by a manager—they may be entitled to coverage regardless of how the employer labels them.

No Coverage? Now What?

The last thing any worker expects after getting injured on the job is to discover that their employer lacks workers’ compensation insurance. Yet it happens more often than you might think. When it does, the path to getting medical care and lost wages becomes significantly more complicated. You may find yourself in a situation where your treatment is delayed, your financial needs are unmet, and your claim is being disputed—sometimes all at once.

For injured workers, this is a nightmare scenario. You’ve done your job. You showed up, followed the rules, and were hurt through no fault of your own. But now, instead of getting the care and benefits you need to heal and move forward, you are forced into a legal and administrative maze.

The Role of the Uninsured Employers’ Fund

Thankfully, New York State has a safeguard in place for workers whose employers are uninsured: the Uninsured Employers’ Fund (UEF). If your employer lacks coverage, the UEF may step in to provide benefits while the matter is being investigated. This fund is designed to ensure that injured workers are not completely left without support just because their employer failed to comply with the law.

However, this does not mean the process will be smooth. Far from it.

When the UEF takes over a claim, it often leads to increased scrutiny of your employment status and the circumstances of your injury. Your employer, facing potential fines and even criminal penalties, may hire an attorney to argue that you were not an employee, or that your injury did not happen on the job. These arguments are not just theoretical—they happen every day in workers’ compensation hearings across the state.

Even if the UEF ultimately accepts the claim, it may take months to resolve these issues. During that time, you may be without income, without adequate medical treatment, and without the ability to return to work. That’s why it’s so important to understand your rights and take steps in advance to protect yourself.

The Legal Consequences for Employers

Employers who fail to maintain workers’ compensation coverage are not only jeopardizing the health and welfare of their employees—they are breaking the law. In New York, failing to secure workers’ compensation insurance is considered a criminal offense, punishable by substantial fines and, in some cases, jail time.

According to Section 52 of the New York Workers’ Compensation Law, an employer that fails to secure coverage may be fined up to $2,000 for every 10-day period without insurance. In addition to penalties, the employer may also be held personally liable for the cost of benefits paid to an injured worker. This includes medical bills, lost wages, and any legal costs associated with the claim.

Despite these harsh consequences, some employers still take the risk, either out of ignorance, cost-cutting motives, or a belief that they won’t get caught. Unfortunately, it’s the injured worker who often bears the brunt of this gamble.

You Don’t Need the Added Stress

Suffering a workplace injury is already traumatic. There are doctor visits, physical pain, and the anxiety of missing work. When you add in uncertainty about whether you’ll receive the benefits you’re entitled to, the stress can become overwhelming.

Delays in treatment can hinder recovery. Delays in wage replacement can force workers into debt or make it impossible to meet basic needs. Legal disputes about coverage can drag on for months or even years. And during this time, you may have to attend hearings, submit documents, or testify about your injury—all while recovering physically and trying to pay the bills.

The workers’ compensation system is meant to provide relief, not add to your burden. But when your employer fails to carry coverage, the opposite often occurs.

What Can You Do To Protect Yourself?

Although you can’t control whether your employer follows the law, you can take some simple steps to protect yourself in advance. Knowledge is power, and when it comes to workers’ compensation, being proactive can save you time, money, and stress.

1. Ask Your Employer for Proof of Coverage

New York law requires employers to post a notice of their workers’ compensation coverage in a visible location at the workplace. This notice should include the name of the insurance carrier, the policy number, and contact information. If you don’t see this notice, ask for it. You have a legal right to know who your employer’s insurance provider is.

2. Check the Workers’ Compensation Board Website

The New York Workers’ Compensation Board provides a searchable database where you can verify whether your employer has valid workers’ compensation insurance. You can access this database at https://wcb.ny.gov. All you need is the name of the business. The search will show the name of the insurance carrier, the effective dates of coverage, and whether the policy is currently active.

This takes just a few minutes and can give you peace of mind—especially if you work in a high-risk job or have concerns about your employer’s compliance.

3. Understand Your Rights as an Employee

Even if you are classified as an independent contractor, you may still be entitled to workers’ compensation under the law. Courts look at a variety of factors when determining whether someone is truly an independent contractor. These include:

• Whether you control your own schedule
  
  

• Whether you supply your own tools or equipment
  
  

• Whether you perform similar work for multiple clients
  
  

• Whether you receive supervision or direction from the employer
  
  

• Whether you are paid hourly, daily, or per project
  
  

If you suspect you’ve been misclassified, speak with an attorney or contact the Workers’ Compensation Board for guidance.

When to Seek Legal Help

If you’re injured and your employer does not have coverage—or if you’re unsure about your classification—you should consult a workers’ compensation attorney as soon as possible. Many attorneys offer free consultations and work on contingency, meaning you pay nothing unless you win your case.

An experienced lawyer can help you:

• File a claim with the Workers’ Compensation Board
  
  

• Challenge your classification as an independent contractor
  
  

• Represent you in hearings
  
  

• Ensure that your causally related medical bills are paid
  
  

• Secure retroactive payments if applicable
  
  

• Advocate for your rights throughout the process
  
  

Remember: the insurance company and the employer have legal representation. You should too.

Peace of Mind Starts with Preparation

By confirming your employer’s coverage in advance, you protect your future self. You don’t want to be scrambling for answers after you’ve been hurt. Just a few minutes of research can make all the difference. If you work in a high-risk field or as part of a subcontracted workforce, this is especially important.

It may feel awkward to ask your employer about their insurance, but it’s your health and financial stability at stake. Good employers will understand that you’re simply looking out for yourself.

Want to Learn More?

If you found this information helpful, you may also be interested in reading:

Can I Handle My Workers’ Compensation Case Without a Lawyer?
This article breaks down the pros and cons of going it alone versus hiring a legal professional. It explores what to expect at each stage of the process and helps you determine whether your case is straightforward or requires expert guidance.