Nys non scheduled loss of use chart In 2010 the task force issued recommended guidelines for the evaluation of medical impairment for non schedule permanent partial disabilities including the spine pelvis respiratory cardiovascular skin brain and pain. Your name and wcb case number.
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To reach the board call 877 632 4996 or email claims wcb ny gov.
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New york state insurance department began developing guidelines for evaluating loss of wage earning capacity.
A schedule loss of use award is reduced by the amount of any prior payments you received while out of work if any. This can include injuries to the brain spine lungs pelvis and other body parts. Non schedule benefits are based on the employee s permanent loss of earning capacity.
All three elements form ime 4 with attachments and narrative are required for a complete ime report. In april part of the new york budget mandated numerous reforms to the new york workers compensation system. Spine pelvis lungs heart brain etc.
Workers compensation law section 15 prescribes the value for a percentage loss or loss of use of body members. A scheduled loss of use award is a type of workers compensation award that is given to people who have permanent work related injuries to their extremities arms hands feet legs. The workers compensation board board can help you understand your schedule loss of use claim.
The new slu guidelines can be found here. It is based on the loss of earning capacity for the worker. Non schedule non schedule is a permanent disability involving a part of the body or condition that is not covered by a slu award e g.
1 6 non schedule awards classification. A non schedule lump sum is for all other permanent impairments including conditions affecting the extremities not covered by a schedule. Workers compensation law 15 3 x required the board to implement new permanency impairment guidelines for scheduled loss of use slu evaluations with an effective date of january 1 2018.
Telephone number with area code brief description of the issue. With non schedule loss it is a permanent disability that is not covered by slu. New york workers compensation non schedule awards.
If it occurred prior to march 13 2007 then the benefits will be payable for the duration of the partial disability. When contacting the board please have the following information ready. Weeks by percentage loss of use of body part for a table containing the appropriate number of w eeks of compensation provided by percentage of loss.
The ime evaluator must fill out the ime 4 cover sheet along with the appropriate listed attachments for either schedule loss of use and or non schedule permanent partial disability. This is different from the kinds of awards given to people with classified injuries which are permanent work related injuries to non extremities back head neck organs etc. The ime evaluator should also provide a narrative report.
Under new york workers comp law a schedule loss of use slu award may be made when a claimant has reached maximum medical improvement and the claimant s body part s have a permanent loss of use as a result of their work related injury.
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