QUESTION: How is a schedule loss of use award calculated in New York?
ANSWER: Calculating an injury or ill workers’ schedule loss of use is difficult. It requires several calculations and important pieces of information. This information includes both salary data but also the opinion of medical providers. Usually, the opinion of the medical providers will be contested or disagreed upon, especially when a worker’s total amount of disability is contested or undermined by an independent medical examiner, or IME doctor. That is why claimants who have a schedule loss of use claim in New York should call an experienced workers’ compensation lawyer in NYC for help.
After you have suffered a work-related injury or illness, you will treat with medical providers to heal your ailment or condition. Most times that will result in a complete recovery. Sometimes that does not. That could be either because of the severity of your injury or factors unique to you (i.e., older age, preexisting injuries).
If an injury or illness does not improve after a certain amount of time, that is known as reaching maximum medical improvement (MMI). This is considered a permanent disability or injury. When you have a permanent injury or illness, you are assigned a percentage for that disability which is calculated using the schedule loss of use based on your average weekly wages.
A schedule loss of use is set by the Workers’ Compensation Board and lists the common body parts and extremities that could be injured or impaired. It also lists the maximum number of weeks that a person could receive compensation for if he or she is deemed to have a 100% loss of use of that body part.
The following is the current schedule loss of use:
If the injury body part is not on this schedule, it may be considered a nonschedule loss of use which is another chart.
After you have reached MMI and have determined to have a permanent injury or disability, you will be evaluated for the percentage of loss. This could be by an IME doctor, or from your treating physicians that the insurance adjuster agrees is appropriate.
Your average weekly wages are also determined. This is your total income for the last 52 weeks before the injury or illness, divided by 52 to determine the weekly amount. You will be entitled to recover up to two-thirds (2/3s) of those wages.
Once these figures are established, the calculation would go something like this:
For an arm injury:
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