Legal Question in Workers Comp in New York

Re: assisted living

Yes. Unless you opted for a section 32 settlement.

Re: assisted living

The easy answer is yes, the cost of an assisted living facility is possibly covered by Workers Compensation. However, the more difficult question is: 1. Whether there is a true medical need and, most importantly;

2. Whether that need was caused by the work injury itself.

Many times these issues are highly litigated...not so much on actual "need" but more so on the issue of causation. For example the need for an ALF may be due in part to a combination of impairments and not just the compensation injury. So for example if there was an older worker who has a work injury but who also has serious impairments like alzheimers, a stroke, etc., the compensation carrier is most assuredly going to point the finger at those conditions as being the "cause" for the need of the ALF.

The Board tends to scrutinize these types of requests quite closely. As people tend to live much longer than they did when the system was first created, there has been an incredible rise in the demand for ALF services. As always under those circumstances it will come down to how well your doctor can articulate the need and causal connection of that need to the work injury and how well that opinion is presented in Court.