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October 2018

When Can I Receive Permanent Disability Benefits After a Workers’ Comp Claim?

By | Workers Compensation

If you have become permanently disabled from a workplace injury, you may be able to receive permanent disability benefits. Before receiving these benefits, you will have go through lengthy legal and medical steps required by New York State to show that your medical condition isn’t likely to change and that it either prevents you from working at all or limits your ability to work and earn your former wages. If you have completely recovered from your injury, you will not be eligible for further indemnity benefits, but you remain eligible for medical treatment.

To qualify for any workers’ comp benefits you must show that you meet all of the basic eligibility requirements such as

• Your employer must have workers’ comp insurance

• You must be an eligible employee at that company

• You must have an injury or illness that’s covered by workers’ comp and is work related

• You must file a workers’ comp claim under the procedures and deadlines in New York State

• You must follow New York State’s rules for getting medical treatment from a workers’ comp treating doctor

To even be considered for permanent disability benefits, your workers’ comp treating doctor needs to prove that you’ve reached a plateau in your recovery. This means that your condition isn’t expected to improve any further with more treatment. This is known as maximum medical improvement (MMI).

It may take you a few months to a few years to reach MMI after you were first hurt on the job. The degree of severity of your injury will have the biggest impact on how long it takes. A broken bone will differ from exposure to toxic chemicals resulting in cancer or other occupational illness.Other factors such as the medical treatments available for your injury or if your insurance company has been dragging their feet on approving any procedures or surgeries may come into play.

Once your doctor has determined you’ve reached MMI, the process starts to determine whether you have any and if so, how much permanent disability. This is the time when you stop receiving temporarily disability payments if you have been out of work and they haven’t run out yet. Typically, your treating doctor will say whether you have a lasting medical condition or lost function otherwise known as an impairment, that resulted from your work-related injury or illness. An impairment can be anything from a bad back to a missing limb to a painkiller dependency from medication you had to take for your injury.

Your insurance company may request an independent medical examination (IME) to determine what your permanent impairments are.  States have different criteria for using the medical information about impairments to decide whether injured employees have permanent disabilities that affect their ability to perform certain tasks at work or to even work at all. The result of this process is called your “loss of wage earning capacity”, (LOWEC)  and is expressed in a percentage.

There are times you don’t have to prove that you can’t work at all in order to receive permanent disability benefits. If you lost your eyes or an appendage you may already be considered permanently disabled. If you have a combination of permanent impairments that add up to a 100% disability rating, you may also qualify for permanent disability benefits. If your disability rating is less than 100%, you may be able to receive some kind of  permanent partial disability benefits.

Once the Worker’s Compensation Board hears from a doctor that you have a permanent disability, they will begin the process of establishing your level of disability. If there is any sort of dispute,  whether it is over the amount of permanent disability to if you have any lasting impairments, you should contact a workers’ compensation lawyer as soon as possible. Since the process is complicated, insurance companies and their lawyers do everything in their power to keep their costs down by minimizing or denying permanent disability benefits. This is when you need an experienced attorney representing you and helping protect your rights.

Unfortunately, permanent disability benefits may not necessarily last the rest of your life. If you are classified  totally and permanently disabled, you’ll usually receive  lifetime  benefits,  but if you only have permanent partial disability you may be limited to how long the benefits will last. Whether your benefits are for partial or total permanent disability, you may be able to opt for a lump sum payment in a workers’ comp settlement. Losi & Gangi Attorneys are here to help answer any of your workers’ compensation  questions and ensure you are fairly represented in your worker’s compensation claim.. Give us a call today at 716-854-1446 and one of our attorneys will assist you in receiving the compensation you deserve.

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