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The length of time for which a person may be entitled to collect compensation depends on his or her degree of disability as determined by a health care provider. A person may be either totally or partially disabled. Under workers’ compensation, total disability is an inability to do any kind of work at all. Partial disability means that a person can do some type of work, even if it is not the type of work they were doing at the time of the accident.
If a worker suffers “Permanent Total Disability” in New York and his or her wage-earning capacity is permanently and totally lost, there is no limit on the number of weeks payable. The 2012 New York State Guidelines for Determining Permanent Impairment and Loss of Wage Earning Capacity directly addresses how disabilities are to be compensated.
For less-than-total disability, benefits are payable for a maximum number of weeks as determined by the claimant’s loss of wage-earning capacity. The maximum number of weeks is set forth in statute as follows:
- 525 weeks for loss of wage earning capacity of greater than 95%
- 500 weeks for loss of wage earning capacity of greater than 90% thru 95%
- 475 weeks for loss of wage earning capacity of greater than 85% thru 90%
- 450 weeks for loss of wage earning capacity of greater than 80% thru 85%
- 425 weeks for loss of wage earning capacity of greater than 75% thru 80%
- 400 weeks for loss of wage earning capacity of greater than 70% thru 75%
- 375 weeks for loss of wage earning capacity of greater than 60% thru 70%
- 350 weeks for loss of wage earning capacity of greater than 50% thru 60%
- 300 weeks for loss of wage earning capacity of greater than 40% thru 50%
- 275 weeks for loss of wage earning capacity of greater than 30% thru 40%
- 250 weeks for loss of wage earning capacity of greater than 15% thru 30%
- 225 weeks for loss of wage earning capacity of 15% or less
Before a determination is made on the classification of the disabilities there must be a finding by a medical professional that the injured worker has reached maximum medical improvement (MMI). This means the claimant has recovered from the work related injury to the greatest extent that is expected or no further improvements in his or her condition is reasonably expected. MMI is typically determined after six months from the date of injury or disablement in cases not involving surgery or fractures.
A worker who becomes sick or injured on the job is also eligible to receive workers’ comp benefits that pay for medical expenses, including those that are necessary to diagnose and treat a claimant’s injury. Compensation may also cover illnesses and diseases that are the gradual result of work conditions, such as lung disease, heart conditions, nervous system disorders and noise-induced hearing loss. Generally, compensation for doctor recommended medical treatment is ongoing for the entire recovery from the work-related injury or illness.
Injured workers must see a doctor at least once every six weeks in order to prove that they are still disabled. Sometimes, there is not a simple agreement between the parties as to the extent and nature of the claimant’s residual permanent disability. In such a case, there may need to be a trial.
Weekly workers’ compensation death benefits will be paid to the surviving spouse until he or she remarries or dies, according to New York Workers’ Compensation – Article 2 – § 16 Death Benefits. Death benefits to children shall be payable so long as they are under the age of eighteen years, or under the age of twenty-three years if enrolled in an accredited educational institution and attending as a full-time student.
