Workers’ compensation is a type of insurance that provides replacement of medical expenses and wages to employees who are injured in the scope of their employment. It relinquishes the employee’s right to sue the employer for the tort of negligence.
If you’re wondering how your disability it classified in NY, the Workers’ Compensation Board has developed a set of classifications in order to determine how much money is paid out for a disease or injury caused by a job. An injury must meet certain criteria, such as debilitating, chronic or degenerating. The classifications include permanent total disability and permanent partial disability. With permanent total disability, the employee’s ability to earn is permanently lost. With permanent partial disability, the employee’s ability to earn is partially lost. Depending on the illness or injury, those worker’s compensation benefits are temporary.
In addition, there are degrees of temporary disability. In order to substantiate, those injuries must be reviewed by a medical professional every 90 days. Temporary partial disability means the employee’s ability to work is partially lost but only for a limited time period. Temporary total disability means the employee’s ability to work is totally lost but only for a limited time.
When an employee’s illness or injury is categorized as permanent partial disability, benefits that may be given are based on the following:
Schedule Loss of Use (SLU): An SLU is when a worker loses usage of an upper extremity, such as the wrists, elbows, hands, arms or shoulders. An SLU is also given with the loss of usage of lower extremities, such as knees, legs and hips. The award given is a percentage that directly translates into the number of weeks assigned by the law. For example, total loss of arm use equates to 312 weeks of worker’s compensation.
Non-Schedule involves permanent disability that meets the criteria under permanent impairment guidelines. These include injuries like degenerative chronic conditions, spine injuries and psychological injuries. If the injury occurred after 2007, it may entail lifetime benefits. If a worker is deemed incapable of gainful employment, they are entitled to lifetime benefits.
Worker’s compensation law measures the number of weeks of benefits based on loss of wage-earning capacity (LWEC). The LWEC is decided based on age, experience and education. The rate of benefits is calculated either on the reduced earnings or to the percent LWEC.
Proving Permanent Total Disability
One important factor in proving a permanent total disability case is to obtain quality expert medical opinions. These experts can determine functional impairment and work restrictions. Plus, vocational experts can be helpful in establishing permanent total disability. A vocational expert can analyze the work restrictions and state what jobs would be impossible for the person to perform. This expert can also cite studies and statistics proving why the person cannot perform the job. Proving permanent partial disability is generally the same as proving permanent total disability.
When To Lawyer Up
Not all injured workers need a lawyer for their worker’s compensation claim. But, there are times that you may. If your claim is denied by the insurance company, it’s time to lawyer up. The insurance company may argue that your injury was not work-related or that you filed too late. A worker’s compensation attorney has the legal tools to provide evidence at your hearing. If your permanent disability rating is disputed, it’s time to lawyer up. Most awards and worker’s comp settlements are calculated based on your disability rating. An attorney can assist you with getting a medical exam to convince a judge that you’re entitled to a higher rating. If you have a preexisting condition, it’ll be an uphill battle with the insurance company. It’s best to have an attorney on your side to dispute this. And if you’re having difficulty getting the medical treatment you need, an attorney can put pressure on the insurance company to approve treatment. If you can never go back to work, an attorney can help structure the benefits to last into the future. If you’re receiving other government benefits, such as Social Security Disability, an attorney can minimize how much these benefits will be reduced. If the insurance company makes a lowball offer, you’ll definitely need an attorney to represent you at the hearing. It’s like a mini-trial.
Kaplan Lawyers PC is a New York law firm with years of experience in worker’s comp claims. They can assist you in understanding the law and help you gather the right information for getting benefits. They will ensure that you get the maximum amount of benefits available to you and the best medical treatment. In addition, they will fight hard to advocate to you if you have a permanent partial disability or a temporary partial disability. Kaplan Lawyers PC has experience in a broad range of worker’s comp cases, including construction site injuries, manufacturing injuries, commercial driving injuries and much more. If you have any questions or concerns about your worker’s comp claim, give Kaplan Lawyers PC a call. They will be happy to answer any of your questions and will give you a free phone consultation.