Does your permanent injury entitle you to compensation?
What is a Schedule Loss of Use award?
A Schedule Loss of Use (SLU) award is a cash benefit to pay you for the loss of earning power resulting from a permanent functional impairment of a body part as a result of your on-the-job injury.
ASchedule Loss Of Use award may be made for injuries to any of the following:
- Arm (shoulder and elbow)
- Hand (wrist and forearm)
- Fingers and/or Thumb
- Leg (hip and knees)
- Foot (ankle)
- Toes and/or Great Toe
- Eyesight (loss of vision)
- Hearing (loss of hearing)
- Disfigurement (face/scar, neck, scalp)
Who is eligible for a Schedule Loss Of Use award?
To be eligible for an schedule loss of use award, you must meet the following requirements:
- You have recovered to the greatest extent possible from your injury
- Your doctor has submitted a medical report that follows the current Permanent Impairment Guidelines.
- In the report, your doctor must state that you have reached maximum medical improvement (MMI).
- You have a permanent loss of function in the injured body part as a result of your on-the-job injury.
Permanent loss of function may result from damage to bone, muscles, cartilage, tendons, nerves, blood vessels and other tissues.A Schedule Loss Of Use award compensates you for permanent loss of earning power, as determined by the Workers’ Compensation Board (Board) and consistent with Workers’ Compensation law and guidelines.
How is MMI determined?
You should ask your doctor about your progress and whether you have reached MMI. When your doctor says you have reached MMI, he or she must submit a medical report to the Board that states that you are at MMI. The report must include an examination of the injured body part, and state the percentage of functional use you have permanently lost in the body part you injured.For example, the report may state that you have 25% less function than you had before your injury. This is also called a schedule loss of use, or SLU.
What happens after a doctor’s medical report is submitted?
- If the insurer agrees with your doctor’s schedule loss of use percentage, then that percentage will be used to calculate the number of weeks of benefits and the payment you will receive.
- If the insurer does not agree with your doctor’s percentage, the insurer may obtain an opinion from its consultant or Independent Medical Examiner (IME).
- The Board will consider the medical reports on permanency and SLU percentage from your doctor and the IME, and will issue a decision about your schedule loss of use percentage.
- This percentage will then be used to figure out the number of weeks of benefits and the payment you will receive.
- After the decision is filed, the insurer has 10 days to pay. If there is a dispute, either party can appeal within 30 days of the decision.
How much is an SLU award?
Your schedule loss of use award is determined by Workers’ Compensation law (statute), which contains a schedule (list) of the maximum number of weeks of benefits you can receive according to the body part you have permanently injured. The schedule is below:
- Arm: 312 weeks
- Leg: 288 weeks
- Hand: 244 weeks
- Foot: 205 weeks
- Eye: 160 weeks
- Thumb: 75 weeks
- First Finger: 46 weeks
- Second Finger: 30 weeks
- Third Finger: 25 weeks
- Fourth Finger: 15 weeks
- Big Toe: 38 weeks
- Other Toe: 16 weeks
Using this schedule, your award is calculated based on the following:
- The body part you injured.
- The percentage of loss of function or schedule loss of use % as decided by the Judge.
- Your average weekly wage.
Your average weekly wage (AWW) is based on your total gross earnings for the 52 weeks before the date of injury or illness (not take-home pay), including overtime and other compensation. Your AWW is calculated by dividing your total gross earnings by 52. For example, if your gross earnings are $”x”, you would divide “x” by 52 to obtain your AWW.
Maximum Weeks Allowed of SLU Benefits: 312
Percentage of Loss of Use: 25%
Duration of Weekly SLU Benefits (312 x 25%): 78%
Average Weekly Wage: $900
Weekly SLU Benefit (AWW x 2/3): $600
*Total Amount of SLU Award (78 x $600): $46,800
*Any prior payments of temporary benefits will be subtracted from the total SLU award.
How are awards paid?
Any temporary benefits you have already been paid will be deducted from your SLU award. Your employer may be reimbursed any wages paid to you while you were out of work. These funds will also be deducted from your schedule loss of use award. The remaining amount will be paid in one of the following ways:
- You’ll get your regular workers’ compensation checks until the schedule loss of use award is fully paid, or
- You can receive a lump sum payment of your schedule loss of use award. If your decision is rendered at a hearing, you can ask for the lump sum at that time, or you can write to the Board to request it. The Board will then direct the insurer to issue you a check for the lump sum.
If you have questions about your eligibility for certain workers’ compensation benefits, or you believe you are not receiving your full benefits, call us immediately. We hoped this post about workers comp “how do I get paid” helped. We will fight for you to ensure you receive the maximum benefits possible.
Source: http://www.wcb.ny.gov/content/main/Workers/ScheduledLossUse.jsp