If you’re bouncing back from an injury or helping someone else through it, it’s important to understand what permanent disability benefits cover and how they compare to temporary wage benefits. We’ll break it all down, go over who qualifies, and share some tips to help you get the most out of your benefits.
Temporary Benefits
Temporary benefits are payments that help cover your lost wages while you’re off work or working fewer hours because of an injury. It doesn’t matter if you’ve got a broken foot, a sprained ankle, or a torn rotator cuff—the rules are the same. These benefits kick in as soon as your injury forces you to take time off. But once you’re back at work and making the same (or more) than you did before, they stop.
Permanent Benefits
Permanent benefits come into play if your injury turns out to be, well, permanent. This happens when you hit what’s called Maximum Medical Improvement (MMI). Basically, that’s when doctors decide that no amount of treatment will make your condition any better—you’ve reached a plateau. If you still have ongoing issues at that point, your injury is considered permanent, and permanent benefits are assessed. Unlike temporary benefits, these are calculated based on how much your injury affects you long-term.
Schedulable Injuries
Schedulable injuries are specific injuries to your arms, hands, legs, feet, fingers, or toes. Each of these body parts has a set value based on a legally defined schedule. Basically, if you completely lose the use of one of these body parts, you’re entitled to a certain number of weeks of workers' comp benefits. The actual amount you get depends on how much function you’ve lost, which is something your doctor will determine.
Non-Schedulable Injuries
Non-schedulable injuries are a bit more complicated because they involve core areas like your head, neck, or back. These injuries don’t have a set schedule because they can affect your ability to work in different ways. Instead, compensation is based on both the physical damage and how much the injury impacts your ability to earn a living. For example, a serious back injury might make it impossible to do any kind of physical labor, which could take a big hit on your income.
To qualify for permanent disability benefits, your injury must be considered permanent, meaning you've reached Maximum Medical Improvement (MMI)—the point where further treatment won’t help.
If your disability is work-related, you may be eligible, but there are exceptions. For example, if you have a lasting injury but are earning the same or more than before, you might not qualify for payments since your earning ability hasn’t been affected.
In short, if your injury impacts your ability to work or forces you into a lower-paying job, you should qualify. But if your income hasn’t changed, proving eligibility can be tougher.
Schedulable Injuries
For schedulable injuries, benefits are based on a set schedule that assigns a value to each body part. For example, losing full use of an arm might get you 312 weeks of compensation, while a foot could be worth 205 weeks. The amount you get depends on the percentage of loss—so if you lose 10% of your arm’s function, you’d get 31.2 weeks of benefits. These payments are two-thirds of your average weekly wage at the time of your injury, up to a legal limit.
Non-Schedulable Injuries
Non-schedulable injuries—like those affecting the head, neck, or back—are more complicated. Here, benefits are based on both your physical impairment and how it affects your ability to work. Doctors assess your medical condition, but a judge also looks at how your injury impacts your job prospects. Someone with more education and job skills may be able to return to work more easily than someone with fewer options, which can affect the compensation amount.
If you have both a schedulable and non-schedulable injury, the system considers which injury is more serious and which calculation method provides better compensation—ensuring you get the most appropriate benefits for your situation.
Payment Structure
Getting permanent disability benefits works a little differently than temporary wage benefits. Temporary benefits come in bi-weekly payments while you're out of work or earning less due to your injury. Permanent benefits, on the other hand, depend on the type of injury.
Lump-Sum vs. Bi-Weekly Payments
If you have a schedulable injury, you’ll usually get a lump-sum payment. Once your permanent disability percentage is determined, you receive a one-time payout based on the value assigned to your injury—so you don’t have to wait for checks every two weeks.
For non-schedulable injuries, benefits are typically paid bi-weekly, just like temporary benefits. A judge decides how long these payments will last based on how serious your injury is and how much it affects your ability to work.
Settlements
In some cases, especially with non-schedulable injuries, you may have the option to negotiate a lump-sum settlement, known as a Section 32 settlement. This lets you receive a portion of your future benefits upfront for immediate financial relief. But before taking a settlement, it’s important to think about the long-term impact and talk to a lawyer to make sure it’s the right move for you.
Avoiding Fraud and Malingering
One of the worst mistakes you can make is exaggerating or faking your injury—also known as malingering. When you go in for medical exams, always be honest and put in your best effort. Doctors are trained to spot inconsistencies, and if they think you’re not being truthful, it could seriously hurt your case. Just be real about your pain and limitations.
Staying Focused on Relevant Injuries
Another common misstep is bringing up unrelated injuries during your evaluations. If your case is focused on a specific injury, stick to discussing that with your doctor. Mentioning other minor issues that don’t really impact your ability to work could weaken your main claim.
Keeping Accurate Records
Keeping track of all your medical visits, treatments, and any paperwork related to your injury is crucial. Be sure to document everything, especially any discrepancies or issues during Independent Medical Examinations (IMEs). Take notes, flag any errors in reports, and communicate them clearly with your lawyer. Staying organized will help strengthen your case and ensure any problems get addressed quickly.
Work with a Doctor Who Knows Workers' Comp
Having the right doctor on your side is a game-changer. A doctor experienced in workers’ comp won’t just focus on getting you the best treatment—they’ll also know how to properly document your injury and progress. That paperwork is key evidence in your case and can make a big difference in the outcome.
Get a Skilled Workers' Comp Attorney
A good attorney can make all the difference. They know how to present medical evidence, challenge insurance company doctors, and navigate the complicated world of workers’ comp law. With the right lawyer, you’ll have a stronger case and a better chance of getting the benefits you deserve.
Keep Track of Your IME Experience
Independent Medical Exams (IMEs) can be frustrating, and the reports aren’t always accurate. After an IME, review the report carefully, jot down any mistakes or missing details, and share it with your lawyer. Your firsthand notes can be crucial if the IME doctor’s findings are challenged later.
Stay Involved and Informed
Don’t just sit back and wait—stay on top of your case. Keep in touch with your lawyer, show up to all your medical appointments, and make sure your paperwork is in order. The more involved you are, the better your chances of catching mistakes that could impact your benefits.
Can Chronic Pain Be a Disability?
Yes, chronic pain can qualify as a disability if it seriously affects your ability to work. Since pain is personal and varies from person to person, you’ll need solid medical documentation showing how it limits your job performance or reduces your earning potential. Your doctor’s records will be key to proving your case.
What If My Job Can’t Accommodate My Permanent Restrictions?
If your employer can’t meet your permanent work restrictions, you may qualify for additional benefits. This often happens with larger companies that have strict policies about returning workers with partial disabilities. While this isn’t always a workers’ comp issue, it could involve employment law. Talking to a lawyer who specializes in that area might help you find other options or protections.
How Are Multiple Injuries Calculated?
If you have multiple injuries—like an ankle and both knees—each one is evaluated separately using the workers’ comp schedule. The disability percentages for each body part are calculated individually and then combined to determine your total compensation. This ensures you’re fairly paid based on how much your injuries impact your ability to work.
What If an Old Injury Gets Aggravated at Work?
If an old injury flares up due to a work accident, you could still qualify for benefits. A doctor will need to document how much of your current condition is due to the old injury versus the new aggravation. This way, you’re only responsible for the original injury, and workers’ comp covers the new work-related damage.
How Do Permanent Disability Payments Differ from Temporary Benefits?
Temporary benefits come as bi-weekly checks while you’re out of work or earning less. Permanent disability payments work differently—schedulable injuries are usually paid in a lump sum after your disability level is determined, while non-schedulable injuries are paid bi-weekly over a set period based on how severe your injury is and how much it affects your ability to earn.
If you have any questions or need further assistance, feel free to reach out. I’m here to help you understand your rights and ensure you get the benefits you deserve.
You can contact me, Rex Zachofsky, at 212-406-8989. Whether it’s a quick question or you need comprehensive support, don’t hesitate to give me a call. We’ll work together to make sure you’re taken care of every step of the way.
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