AREAS & TOPICS PROTECTING THE RIGHTS OF THE INJURED AND DISABLED

Schedule Loss Awards


          A "Schedule Loss of Use" (generally known as an "SLU") is a type of benefit award which may be made after an injured worker rehabilitates and is considered by his/her own doctor, or by the insurance company's consultant physician, to have achieved "Maximum Medical Improvement" (hereafter "MMI") for his/her work-related injury or illness.

          An SLU benefit award is measured in terms of weeks. A particular loss-of-use percentage is first stated by a medical expert. This percentage is then converted into a corresponding number of weeks' worth of Workers' Compensation benefits according to the schedule printed at Appendix II of the June 1996, Workers' Compensation Guidelines. Finally, the injured worker's own maximum weekly benefit is multiplied by the number of weeks indicated on the schedule. The resulting benefit is the worker's SLU for the particular injury suffered.

Appendix II   -  View with Adobe Reader
See the scheduled rates for each type of SLU.

          For instance, if a particular worker earned $600 per week before tearing a rotator cuff in his shoulder while at work, and this injury required surgery to repair, then approximately one year after the surgery a doctor might give an opinion that the worker has reached Maximum Medical Improvement.  At MMI, the insurance company's doctor states that the worker has lost 10% of the function of the worker's injured arm under the schedule published at Appendix II (perhaps only because the worker is now much more susceptible to re-injury, for example).  10% of an arm is worth 31.2 weeks under the published schedule.  A $600 Average Weekly Wage means the worker gets $400 per week (a worker's maximum benefit rate is 2/3 of his or her Average Weekly Wage) toward the SLU.  31.2 X $400 = $12,480.  Thus, the worker is entitled to an SLU worth $12,480 due to the rotator cuff tear suffered while at work.  If the worker took 6 weeks off from work to rehabilitate after the surgery, and got paid his maximum benefit while off from work, the final compensation payment to the injured worker will be $10,080.  This is because previous amounts paid will be considered only as advance payments on the eventual award due under Schedule II.

          Of course, very often the insurance company's doctor states a lower percentage of loss while the injured worker's own physician states a much higher percentage. In this situation, the insurance company's lawyer will cross-examine the injured worker's doctor to try and weaken that doctor's stated medical opinion. Claimants who fail to obtain their own experienced legal counsel may forfeit valuable benefits if they are not able to effectively cast doubt upon the medical opinion given by the insurance company's doctor. If a judge has one weakened opinion, and one that has never been vigorously and thoroughly challenged, it doesn't take a rocket scientist to figure out which expert's opinion might be most likely to carry the day and determine how much money the injured worker will obtain via the SLU award.

          Indeed, often insurance companies will agree to pay a higher SLU award (than is supported by their own expert's opinion) just to avoid lengthy and costly litigation over a reasonably-close question. Thus, claimants with attorneys may achieve better results compared with unrepresented claimants.

          If you desire representation in order to assure you get every benefit the law will provide, including the possibility (not everyone gets one) of an SLU award, please Contact Us today.

                                                       

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Vincent J. Criscuolo & Associates
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Phone: (585) 232-3240