Workplace accidents can cause amputations, restrictions on mobility, and other serious injuries. If you have lost partial or total functional use of a body part, you may be eligible for a scheduled award through workers’ comp. (For other types of benefits, see our page on workers’ compensation benefits.)
Most states have a schedule of injuries in their workers’ compensation laws. This is a chart that lists and values injuries that involve the loss of use of a body part or sense (such as hearing or vision). When you lose the use of a listed body part, workers’ comp refers to this as a scheduled or specific loss. Most states’ schedules include the loss of vision or hearing or the loss of use of an arm, leg, hand, foot, finger, and toe. However, some states include other types of injuries. For example, New York includes scarring and disfigurement on its schedule, and Connecticut includes various organs, such as the lungs, heart, and liver.
In most states, a scheduled or specific loss can occur with or without a work-related amputation. For example, a crush injury may not result in your hand’s amputation, but may prevent you from gripping, grasping, and holding items. In most states, this inability to use your hand will qualify you for scheduled loss benefits.
In general, you must reach maximum medical improvement (MMI) before you are eligible for a scheduled loss award. You reach MMI once your medical condition has stabilized and your doctors do not believe there will be any additional improvement. Once you reach MMI, your doctor will assign you a permanent disability rating. If your injury appears on the state schedule, you will receive a scheduled loss award.
Workers’ compensation is state-based, meaning that your benefits will vary depending on where you live. However, you typically will receive a set weekly amount for the number of weeks set out in the schedule of injuries. In many states, this amount is two-thirds of your average weekly wage. Scheduled loss awards are usually paid even if you’re able to return to work immediately.
The value of a scheduled loss varies from state-to-state. For example, the award for the loss of an arm is as follows:
In several states, you can receive compensation for a partial loss. If you suffer a partial loss of a scheduled body part, you will receive that percentage of the listed award. For example, if your doctor assigns a 25 percent loss of use of your arm in New York, you would receive 78 weeks of scheduled loss benefits.
A minority of states, including Washington, list specific dollar amounts for scheduled losses instead of weeks of payment. In these states, you will receive a lump sum award according to the amount listed in the schedule.
In some states, your scheduled award may be reduced by the number of weeks (or amounts) that you have already received temporary total disability benefits.
The majority of states offer scheduled loss awards to eligible workers. A small number of states do not have a schedule of injuries—including California, Florida, Nevada, and Texas. However, this doesn’t mean you won’t receive compensation for the loss of use of a body part in these states: You may still be eligible for an unscheduled award (described below). In some states, you may be eligible for an unscheduled award if you’re still unable to earn your normal wages after your scheduled loss award runs out.
Not all injuries are listed on a state’s schedule. For example, if you have a work-related back, lung, or brain injury, you are not eligible for a scheduled loss award in most states. However, you may still be entitled to other workers’ comp benefits, sometimes called “wage loss benefits” and “permanent disability benefits.” Your right to benefits may depend on whether your state bases eligibility on your level of impairment or wage loss.
These two systems can lead to different results. For example, suppose a worker suffers a head injury, causing memory and concentration problems. However, her employer has simple work that she is capable of performing. In an impairment-based state, she may be eligible for PPD benefits if her doctor assigns an impairment rating (regardless of her ability to work). In a wage-loss state, she will only be eligible for a wage loss benefits if she earns less at the new job or is expected to suffer a decrease in earning capacity in the future.