Those with severe and permanent on the job injuries may be eligible for a Schedule Loss of Use (SLU) award. This is a cash benefit to compensate injured employees for the loss of future earnings due to the permanent functional impairment of a body part. SLU may be awarded 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)
To be eligible for an SLU award, you must meet specific criteria, including having recovered as much as possible from the injury, also known as having reached maximum medical improvement (MMI). You must also have a physician submit a report stating you have reached MMI and have a permanent loss of function resulting from your injury. Permanent loss of function can be the result of damage to bone, muscles, cartilage, tendons, nerves, blood vessels, and other tissues. The amount of your SLU is determined by the Board, consistent with applicable Workers’ Compensation laws and guidelines.
Determining maximum medical improvement (MMI)
As you progress through treatment and recovery, your doctor will evaluate and inform you of your progress toward MMI. Once they have determined you have reached MMI, they will submit a medical report to the Board indicating you have reached MMI. Your doctor will examine the injured body part and report on the percentage of functional use you have permanently lost in the injured body part. For example, your physician’s report may indicate you have 50% less function than before the injury occurred.
What happens after your doctor files the report?
The insurance company will review the doctor’s report regarding your on-the-job injury. If they agree with the SLU percentage assigned by your doctor, that will be used to calculate the number of weeks of benefits and total SLU payment you are eligible to receive.
If the insurance company disagrees with the percentage assigned by your doctor, they may have a consultant or Independent Medical Examiner (IME) verify the percentage. The Board will then review both the report from your doctor and the IME. The Board will then make a decision regarding your SLU. After the decision is filed, the insurance company has ten days to pay. In the case of a dispute, either party may file an appeal within 30 days of the decision.
Park Avenue Trauma’s physicians assist patients suffering from job-related injuries, i.e., New York State Workers’ Compensation claims. Our well-trained staff of medical doctors, physical therapists, and administrative personnel are dedicated to providing our patients with the highest quality care available.