Suffering a permanent injury at work in New York can be devastating, not just physically, but financially. You might be worried about Lost Money Ny due to your inability to work at full capacity. Fortunately, New York State Workers’ Compensation provides a crucial benefit to help workers recoup some of these financial losses: the Schedule Loss of Use (SLU) award. This guide, brought to you by money-central.com, your trusted source for financial expertise, will explain everything you need to know about SLU awards and how they can help you recover lost income after a workplace injury in NY.
What Exactly is a Schedule Loss of Use (SLU) Award?
A Schedule Loss of Use (SLU) award is a monetary benefit specifically designed to compensate you for the decrease in your ability to earn wages resulting from a permanent functional impairment of a body part injured on the job. Think of it as compensation for the long-term impact your injury has on your earning potential. The Workers’ Compensation Board determines the amount of this award, carefully considering New York Workers’ Compensation law and established Permanent Impairment Guidelines. This ensures a fair assessment of your lost money NY situation due to the injury.
SLU awards are applicable to injuries affecting various body parts, including:
- Upper Extremities: Arm (encompassing shoulder and elbow injuries), Hand (wrist and forearm), Fingers and/or thumb.
- Lower Extremities: Leg (hip and knee injuries), Foot (ankle), Toes and/or great toe.
- Sensory Organs: Eyesight (loss of vision), Hearing (loss of hearing).
- Disfigurement: Significant disfigurement to the face, neck, or scalp resulting from scarring.
Are You Eligible for an SLU Award to Recoup Lost Money in NY?
Eligibility for a Schedule Loss of Use award hinges on meeting specific criteria designed to ensure that the compensation is provided to workers who have genuinely suffered a permanent loss of function and potential lost money NY. You may be eligible if you meet the following key requirements:
- Maximum Medical Improvement (MMI) Achieved: You must have reached a point where your medical condition has stabilized, and further significant improvement is not expected. This is known as Maximum Medical Improvement (MMI).
- Medical Documentation of MMI and Permanent Impairment: Your healthcare provider plays a crucial role. They must submit a medical report to the Workers’ Compensation Board that:
- Adheres to the current Permanent Impairment Guidelines.
- Explicitly states that you have reached Maximum Medical Improvement (MMI).
- Details the permanent loss of function in the injured body part directly resulting from your workplace injury.
- Permanent Loss of Function: You must have a documented permanent loss of function in the injured body part. This loss of function can stem from damage to various tissues, including bones, muscles, cartilage, tendons, nerves, blood vessels, and other bodily tissues. This permanent impairment is the basis for calculating your potential lost money NY compensation.
How is Maximum Medical Improvement (MMI) Determined?
Understanding how MMI is determined is crucial for understanding the SLU process and your potential compensation for lost money NY. It’s a process that involves communication with your healthcare provider.
You should proactively discuss your progress and recovery with your healthcare provider. Specifically, ask them if you have reached Maximum Medical Improvement (MMI). When your healthcare provider determines that you have reached MMI, they are required to submit a detailed medical report to the Workers’ Compensation Board. This report is not just a simple statement; it must include a thorough examination of the injured body part and, importantly, quantify the percentage of functional use you have permanently lost in that body part due to the workplace injury.
For instance, a medical report might state that, as a result of your injury, you now have “25 percent less function” in your injured arm compared to your pre-injury condition. This percentage represents your Schedule Loss of Use, or SLU percentage, and is a critical factor in calculating your SLU award and the compensation for lost money NY.
What Happens After Your Medical Report is Submitted to the Board?
Once your healthcare provider submits the medical report detailing your SLU percentage, the process to determine your award and compensate you for potential lost money NY begins. Here’s what typically happens:
- Insurer Agreement: If the workers’ compensation insurance company (insurer) agrees with the SLU percentage provided by your healthcare provider, this percentage will be accepted. This agreed-upon percentage will then be used to calculate the number of weeks of benefits you are entitled to and the total payment amount of your SLU award.
- Insurer Disagreement and Independent Medical Examination (IME): If the insurer disagrees with your healthcare provider’s assessment of your SLU percentage, they have the right to request a second opinion. They may arrange for you to be examined by their own consultant or an Independent Medical Examiner (IME). The IME will conduct their own evaluation and submit a medical report detailing their opinion on your permanency and SLU percentage.
- Board Decision: The Workers’ Compensation Board then steps in to review all medical evidence. They will carefully consider the medical reports from your healthcare provider and the IME, along with any other relevant medical documentation. Based on this review, the Board will make an official decision regarding your final SLU percentage. This decision is crucial as it directly impacts the calculation of your benefits and the compensation you will receive for lost money NY.
- Payment and Appeals: Once the Board issues its decision, the insurer is legally obligated to make payment within 10 days. If either you or the insurer disagrees with the Board’s decision, there is an opportunity to appeal. Either party can file an appeal within 30 days of the decision date.
How is the Amount of Your SLU Award Calculated?
The amount of a Schedule Loss of Use (SLU) award, which is intended to help compensate for lost money NY, is not arbitrary. It is determined by a clear and structured process outlined in the New York Workers’ Compensation Law. This law includes a specific schedule – a list that assigns a maximum number of weeks of benefits for the permanent injury of different body parts.
Maximum Possible Weeks of Compensation Based on Body Part:
| Body Part | Weeks |
|---|---|
| Arm | 312 |
| Leg | 288 |
| Hand | 244 |
| Foot | 205 |
| Eye | 160 |
| Thumb | 75 |
| First Finger | 46 |
| Second Finger | 30 |
| Third Finger | 25 |
| Fourth Finger | 15 |
| Big Toe | 38 |
| Other Toe | 16 |
Your SLU award calculation is based on three key factors:
- The Injured Body Part: The schedule of weeks is directly tied to the specific body part you injured. For example, an arm injury has a different maximum week allocation than a finger injury, reflecting the varying impacts on overall earning capacity and potential lost money NY.
- The Percentage of Loss of Function (SLU Percentage): As determined by the Workers’ Compensation Board, the percentage of lost function is applied to the maximum weeks allocated for that body part. A higher percentage of loss translates to a larger number of weeks of benefits.
- Your Average Weekly Wage (AWW): Your average weekly wage is calculated based on your gross earnings (before deductions) for the 52 weeks prior to your injury. This includes overtime and other forms of compensation. It represents your pre-injury earning level and is used to determine your weekly benefit rate.
Calculate Your Average Weekly Wage
Example SLU Award Calculation:
Let’s consider a worker who sustained a work-related arm injury and, as a result, has a 25 percent Schedule Loss of Use of that arm. Their average weekly wage (AWW) is $900. Here’s how the SLU award would be calculated:
| Factor | Value | Calculation |
|---|---|---|
| Maximum Weeks for Arm Injury | 312 weeks | |
| Percentage of Loss of Use | 25% | |
| Duration of Weekly SLU Benefits | 78 weeks | (312 weeks x 25%) |
| Average Weekly Wage (AWW) | $900 | |
| Weekly SLU Benefit (2/3 of AWW) | $600 | ($900 x 2/3) |
| Total Amount of SLU Award Before Deductions | $46,800 | (78 weeks x $600) |
It’s important to note that any prior payments of temporary disability benefits you received will be deducted from this total SLU award. This ensures that you are not double-compensated for the same period of lost wages.
How Are SLU Awards Paid Out?
Understanding how SLU awards are paid is crucial for managing your finances after a workplace injury and mitigating lost money NY concerns. The payment process involves considering any prior benefits you may have already received.
Any temporary disability benefits you have already received while unable to work will be deducted from your total SLU award. Additionally, if your employer continued to pay your wages while you were out of work due to the injury, they may be reimbursed from your SLU award. These deductions are applied to avoid overpayment and ensure fairness in the workers’ compensation system.
The remaining balance of your SLU award, after any applicable deductions, will be paid to you in one of two primary ways:
- Regular Workers’ Compensation Checks: You can continue to receive your workers’ compensation checks at your established weekly benefit rate until the entire SLU award amount has been paid out. This option provides a steady stream of income over time.
- Lump Sum Payment: Alternatively, you can request to receive your SLU award as a single lump sum payment. If your SLU decision is made at a hearing before a Workers’ Compensation Law Judge, you can request a lump sum payment at that time. If not, you can submit a written request to the Workers’ Compensation Board to request a lump sum. The Board will then direct the insurer to issue you a check for the full remaining amount of your SLU award. A lump sum can provide immediate financial relief to address immediate needs related to lost money NY.
Do You Have Questions About Your SLU Award and Recovering Lost Money NY?
Navigating the workers’ compensation system and understanding SLU awards can be complex. The New York State Workers’ Compensation Board is available to assist you in understanding your Schedule Loss of Use claim and how it can help with lost money NY due to your workplace injury.
To contact the Board directly for assistance, please call their helpline at (877) 632-4996.
When you contact the Board, please have the following information readily available to help them assist you efficiently:
- Your full name and your Workers’ Compensation Board (WCB) case number.
- Your telephone number, including your area code.
- A brief, clear description of the issue or question you have.
- Any relevant documents or letters you have received related to your case.
For further information, you can also download and print the Board’s pamphlet: Understanding Your Schedule Loss of Use Award
This guide is for informational purposes only and not legal advice. For legal advice, consult with a Workers’ Compensation attorney.
