Scheduled Loss Awards in Workers' Comp

Workplace accidents can cause amputations, restrictions on mobility, and other serious consequences. 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.)

What Is a Scheduled Loss Award?

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.

Maximum Medical Improvement

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.

How Much Will I Get for a Scheduled Loss?

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:

• Illinois: 253 weeks
• Maryland: 300 weeks
• Michigan: 269 weeks
• New York: 312 weeks
• Ohio: 225 weeks, and
• Virginia: 200 weeks.

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.

Does Every State Offer Scheduled Loss Awards?

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.

What Is an Unscheduled Loss?

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.

• Impairment-based approach. In impairment-based states, you may be eligible for permanent partial disability (PPD) benefits if your injury causes a permanent limitation. In these states, a doctor will examine you after you reach MMI and assign an impairment rating expressed as a percentage of disability. You will receive PPD benefits based on this impairment rating, depending on how many weeks your state assigns to a 100% impairment. For example, if your state pays 600 weeks of benefits for a "whole body impairment" and you are assigned a 10% impairment rating, you will receive 60 weeks of benefits.
• Wage loss approach. In wage loss states, you must show that your medical condition prevents you from earning your normal wages before the injury. If you are able to return to work and earn your full wages, you will not receive wage loss benefits. States calculate wage loss differently. Some states base benefits on actual wage loss (your lost earnings at the time of the award), while others calculate your lost wage-earning capacity (what you are capable of earning in the future, based on your training and work experience).

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.

Consult a Workers' Comp Lawyer

Whether your workplace injury is classified as a scheduled loss or an unscheduled loss, you'll benefit from hiring a workers' comp lawyer to handle your claim. An attorney can explain the process, file your claim, and if necessary represent you at a workers' comp hearing.