Best Personal Injury Lawyers in Clay, NY

You must see your doctor every 90 days. Pursuant to 12 NYCRR 325-1.3, claimants need updated medical evidence of their disability every 90 days until they reach permanency.

The Board states that in order to continue to receive ongoing lost-wage benefits, a partially disabled claimant must be attached to the labor market attachment. A claimant must make reasonable efforts to obtain gainful employment consistent with his or her medical restrictions. Partially disabled claimants need only seek employment within their medical restrictions. If a claimant does not make reasonable efforts to look for work consistent with his or her disability, they will be found to have voluntarily withdrawn from the labor market. If a claimant is found to have withdrawn from the labor market, then they will not receive indemnity benefits.

A schedule loss of use (or SLU) is an award for the loss of a body part. The Workers compensation law gives an award to injured workers for the functional loss of a body part. To simplify, if there is a complete loss of a body part, that award would be 100% of the maximum number of weeks that body part. Meaning that you would receive your average weekly wage award for that number of weeks. For instance, in New York, an arm is worth 312 weeks. If you were to have a complete loss of an arm the maximum amount of compensation you can receive for that loss would be 312 weeks. If your average weekly wage was $300 per week, you would receive $200 for 312 weeks or $62,400. Of course it is more complicated than that, but for simplification purposes if this was a 10% loss, it would be worth $6240. Your physician must make a determination as to the percentage of your loss. This cannot occur until you reach maximum medical improvement. The definition of maximum medical improvement cannot occur until at least one year after the injury date or surgery. The time for you to reach maximum medical improvement is also a medical decision for your physician. Workers compensation law

In order for a judge to award a schedule loss of use (SLU), first your doctor must determine that you have reached maximum medical improvement. The doctor must submit their opinion C-4.3 (now CMS 1500) as to the exact amount of your loss. Using the New York State permanency guidelines, doctors will measure functional losses in mobility and assess any other criteria that can impact the level of loss. The insurance company can either accept the SLU opinion by the treating provider or they can schedule an IME for their own opinion. IMEs work for the insurance company to come up with a different opinion than your treating doctor. The parties then can either negotiate a compromise or litigate SLU to have the Board determine the level of loss. The chart below outlines the value for each body part that New York Law makes SLU awards.

Under NY Workers Comp Law, claimants need evidence of their disability every 90 days. The treating provider must be supervised by a lawyer. We also recommend that if you have not seen an actual MD, you request to be seen by a medical doctor at least once. Since the doctor is the person who will actually testify if there is a dispute as to any issue, that person needs to be familiar with you.