A guide to understanding New York workers’ compensation law must start with understanding the different stages of a claim. There are two main stages in every case that determine what the insurance carrier must pay the injured worker. The stage of a case also impacts what medical treatment the carrier will cover. An injured worker should know the difference between temporary and permanent disability status in a workers’ compensation case.
Stage 1: A Guide to Understanding Temporary Disability Status in New York Workers’ Compensation Law
The insurance carrier will pay awards on a case when a claimant is out of work with a temporary disability due to the accident. These payments will be in the form of weekly benefits. The degree of a worker’s temporary disability will impact the rate the insurance carrier must pay. There are different levels of temporary disability.
Total disability means the injured worker cannot work in any capacity. This means the worker cannot perform any job whatsoever due to his or her injury. Marked disability (75%) means the injured worker is limited to sedentary work. Sedentary work means desk work with sitting most of the time. Moderate disability (50%) means the injured worker is limited to light work. And mild disability (25%) means the worker can perform heavier work, however with some restrictions. Understanding these terms is crucial and the Board will use them as a guide in directing the carrier to pay benefits under the New York workers’ compensation law.
The Board determines the level of a worker’s temporary disability through medical evidence. Both the worker’s doctors and the carrier’s doctors (IME doctors) will opine to disability status. It is up the New York workers’ compensation lawyer to argue for the highest disability status possible. If the Board finds a worker to suffer from a temporary partial disability, the worker may have to search for work to receive ongoing payments. This requirement, known as labor market attachment, can be burdensome. A claimant’s failure to look for work can lead to suspension of weekly payments.
Stage 2: Permanent Disability in Workers’ Compensation
A guide to understanding New York workers’ compensation law must include discussion of permanent disability. Permanent disability under New York workers’ compensation law comes in multiple forms: Loss of Wage Earning Capacity (LWEC) and Schedule Loss of Use (SLU). Whether the Board will make an LWEC finding, a SLU finding, or both, will depend on the claimant’s injuries. For example, a spine injury will often result in an LWEC finding.
In comparison, an injury to a joint, such as the shoulder or knee, will usually result in a SLU finding. LWEC versus SLU award will also depend on the injured worker’s work status and whether an injury is a chronic condition. The Board will typically address permanent injury in a case at the later of several months from the accident, or about one year from the worker’s most recent surgery. The Board will not address permanent injury until the worker has plateaued with treatment. There is no set time-frame. Permanent injury is phase two in this guide to understanding New York workers’ compensation law because it affects awards.
The parties will often litigate the level of permanent injury. A SLU award may result in the insurance carrier paying a lump sum money award to the claimant. An LWEC finding will result in a bank of weeks of compensation payable to the claimant when out of work. If the Board finds a permanent total disability, the worker is entitled to lifetime weekly benefits. The severity of the injury is a primary factor in both SLU and LWEC determinations. Contact an attorney right away if you have an active or possible workers compensation case.