State and Federal workers’ comp laws include a schedule of wage payouts for permanent injuries. See if you qualify for a scheduled loss of use award.
A scheduled loss of use (SLU) award is a payout that a worker receives if a specific body part is permanently injured in a workplace accident.
Workers’ comp wage benefits are typically two-thirds of the worker’s average pre-injury wages. SLU rules allocate a maximum number of weeks you can get wage benefits for each type of injury.
You can get an SLU award in a one-time lump-sum payment or on a weekly basis.
If an employee suffers a work injury that isn’t on their state’s list, they could be entitled to an “unscheduled injury” award based on their loss of earning capacity.
Eligibility for a Scheduled Loss of Use (SLU) Award
Scheduled loss of use awards are workers’ compensation payments available in most states for workers who suffer permanent workplace injuries to specific body parts, such as hands, arms, legs, and feet. Vision or hearing loss may also be on a state’s schedule of losses.
Four states don’t offer Schedule Loss of Use awards:
SLU Eligibility Requirements
You may be eligible for a Scheduled Loss of Use award when your workplace injury resulted in the permanent loss of function of a covered body part, and your doctor has determined you’ve reached Maximum Medical Improvement (MMI).
MMI occurs when your doctor decides your medical condition is stable and won’t improve with further treatment.
Most states will pay an SLU award for the total or partial loss of use of a listed body part.
How SLU Awards Are Calculated
Scheduled Loss of Use awards are calculated using the worker’s weekly wage benefit amount, the number of benefit weeks allotted for the body part, and the percentage of loss the worker suffered.
Once an insurer calculates an injury victim’s total award, the employee can receive that amount in weekly payments or as a lump-sum. Most states say that workers must petition their state’s workers’ comp board for a lump sum payment.
If a worker has received weekly wage benefits before the SLU award is determined, those payments get deducted from a worker’s total SLU award.
Case Example: Calculating a Schedule Loss of Use Award
Lisa works as a manager in a grocery store. Her average weekly wage is $1,500. She breaks her leg in a workplace accident and files for workers’ compensation benefits. Her weekly workers’ comp wage benefit is $1,000.
After reaching MMI, Lisa’s doctor determines that she suffered a permanent 20% loss of the use of her leg.
In Lisa’s state, the laws allow a maximum of 300 weeks of compensation for an injured leg. Lisa is entitled to 20% of the 300 weeks for a total of 60 weeks (or 300 x .20).
The amount of her weekly wage benefit is $1,000, so Lisa’s total scheduled loss of use award is $60,000 (60 weeks x $1,000).
If Lisa had already received 20 weeks of wage benefits (20 x $1,000 = $20,000) before the SLU award, that amount is deducted from her total award. Lisa could ask for a lump sum of $40,000 or continue receiving her weekly benefits for 40 more weeks.
Medically Determined Loss of Use Ratings
When your doctor determines you’ve reached MMI they will assign a percentage of loss, sometimes called an impairment rating, to describe how much function you’ve lost in that body part.
For example, if you suffer an arm amputation, then you’d have 100% loss of use. You’d have a lower loss percentage if you still have your arm, but can no longer raise it above your head.
Your doctor will include your percentage of loss in the medical report they send to the insurance board.
If the insurance company disagrees with your impairment rating, they may arrange an independent medical examination (IME) for a second opinion. If so, your state’s workers’ compensation board will determine the appropriate percentage after reviewing reports by your physician and the IME doctor. Once they make a decision, most states allow a worker to appeal the decision within 30 days.
The final impairment rating is part of the SLU payment calculation.
Schedule of Benefit Week Allocations
Each state’s workers’ compensation laws include a schedule, meaning a list or chart of the number of benefit weeks allowed for specific body parts.
For example, the Ohio schedule allocates 35 weeks for an index finger, 175 weeks for a hand, and 225 weeks for an arm. In Georgia, state laws allocate 40 weeks for an index finger, 160 weeks for a hand, and 225 weeks for an arm.
Federal employees must apply for workplace injury compensation through the U.S. Department of Labor’s Office of Workers’ Compensation Programs.
The federal workers’ comp program also has a loss of use schedule for permanent injuries. For example, the federal loss of use schedule allows 46 weeks for an index finger, 244 weeks for a hand, and 312 weeks for an arm.
When Your Injury Isn’t on the Schedule
If an employee suffers a permanent workplace injury not listed on their state’s schedule, they might be eligible for an award based on an overall loss of earning power, rather than a specific body part.
For example, the New York laws will compensate for unscheduled injuries (such as to the brain or spine) based on the injured worker’s permanent loss of earning capacity. The awards range from 225 weeks for a 15 percent or less loss of capacity, up to 525 weeks for loss of wage-earning capacity greater than 95 percent.
As with SLU awards, unscheduled injury awards provide weekly wage payments to the injured worker. In some cases, an employee can opt for a one-time lump-sum payment.
SLU Awards Are Not Settlements
A scheduled loss of use award is not a workers’ comp settlement, and there are several important differences between the two.
Claimants typically give up coverage of future medical care when they settle their claims. The cost of future medical care should be included in the final settlement amount. But with a scheduled loss of use award, medical bills related to your work injury continue to be covered by worker’s compensation.
Settlements usually close workers’ comp cases. Workers get paid, and they’re not able to appeal for increased payments at a later date.
However, if a worker’s body part worsens over time in an SLU case, they can file a claim for an increased SLU award. Most states say injured employees can file for an increase within 18 years of the date of the injury or eight years of the last SLU award, whichever is longer.
If you settle a workers’ comp claim, you may not be able to file an additional claim if you later worsen the original injury.
With a scheduled loss of use, a claimant can file an additional claim if they re-injure their affected body part. However, they have to use up the number of weeks they received in their first case before receiving any further wage benefits.
For example, if you are awarded 20 weeks of wage benefits for an injured hand and only used 10 weeks of benefits before re-injuring the same hand, you have to use up the remaining 10 weeks awarded for the initial injury before you are eligible for additional wage benefits.
Get Help From a Workers’ Comp Lawyer
If you were left with a permanent disability after a workplace accident, it pays to discuss your case with a workers’ compensation lawyer. Most work injury cases are not clear cut or limited to one specific body part.
The rules for state or federal workers’ compensation claims can be confusing, especially when it comes to SLU awards.
Most workers’ comp attorneys offer free case reviews, and most states limit attorney fees for workers’ comp cases. Seek legal advice today to protect your claim for disability benefits.
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