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Classification rating VS. Scheduled loss of use?
#1
Hello. I posted a couple prior questions prior to this because I was going in to an exam to be rated for permanency by the "independent" doctor that the IC sent me to. So I went last week and felt a bit nervous as the man really did nothing as far as the physical aspect of the exam. The paperwork part was about 10-15 minutes, reviewing treatments, medications etc. and basically just to make sure he had all current information.

I received his report yesterday in the mail on his opinion as to my permanency rating. Mind you, I have not gone to my OS yet to be rated. OH, the other thing is my attorney may not even want me to go get rated by my OS because he (my OS already said nobody gets 100% disability for hands) so what would the point be right? Or can they go higher than 75% and less than 100% This is what the IME Doctor had to say:

"Based on further review of this folder, I found this claimant's condition to be at or near MMI and could proceed to finalization. In accordance with the medical guidelines of the Comp. Board of June 1996, I anticipate the claimant will qualify for a classification of a marked PPD concerning both of her hands (75% earning capacity loss)."

From what I was explained briefly by the paralegal at the firms office (attorney in court) having a classification, I could end up getting paid forever because they put a max cap on time for classification payments (in NY) after my case started. BUT, I will be under the thumb of comp forever........The downside is no lump sum award to bail my behind out of major debt, probably sending me to bankruptcy. They (attorney) was shocked that this doctor came back with such a high rating for classification (which I do not understand) but it puts me high enough that who is gonna hire me with these hands, but not disabled enough to qualify for SSD based on hands alone... (i did apply because i do have other issues like depression, anxiety, which have gotten way worse since this all started almost 6 years ago)

So, anybody have any insight as to the english version of "classification vs. lump sum award" in NYS. I was also told if I was approved for SSD there may not be an offset....I am so darn confused I want to scream and My attorney is on VACATION until the end of next week now~ figures right? lol.
I have tried reading it on the nys comp website and am reading it as if it was in French or something.....i don't know!

thanks!Shy sorry so confusing
Live, Laugh, Love ~
 
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#2
(06-16-2011, 04:56 PM)sonny1 Wrote: So, anybody have any insight as to the english version of "classification vs. lump sum award" in NYS.
I have tried reading it on the nys comp website and am reading it as if it was in French or something.....i don't know!

thanks!Shy sorry so confusing

I think you are confusing how you are rated with how you are paid.

according to the state website (http://www.wcb.state.ny.us/content/main/...yClass.jsp)
there are 2 methods of rating your permanent disability:
1)when some of your wages are continuing to be lost and you are at MMI you will receive permanent partial disability while the functional disability and the wage loss exits. (this was limited for injuries after 3-13-2007)
2) scheduled loss of use payments for a fixed number of weeks (depending on the schedule) without the wage loss requirement.

I believe both of the above default to periodic payments but there is process for requesting the permanent disability be converted & paid in single lumpsum payment.

if the parties negotiate a buyout of the comp claim all benefits including medical are paid in a lumpsum.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
Ok so let me see if I am understanding what you have explained (please be patient with me, thank you). Even though they rated me with a classification instead of a scheduled loss of use, I can ask to be paid a lump sum anyways but I would have to close out my medical? My case started in January of 2006. (NY). I was under the impression that a scheduled loss of use was an automatic lump sum award and a classification was ongoing weekly/biweekly checks.

I will be required to still look for work weekly as long as I continue to collect checks, which means that they can challenge anything at any time to bring me back to hearings just because....IF I choose to continue getting checks. If I don't continue getting checks, I lose my medical, with a buyout, but who is to say that would be in the right ball park?! UGH>

So does the 75% earning capacity loss really mean like 75% disabled or no? I was planning on them doing a scheduled loss of use evaluation which would have said xxx% is the loss of use in this hand and xx% in the other hand....not that it would have been any easier for me to understand! I ask that because I am in the appeal process of SSDI and do not want to be misinformed about "true degree of physical disability" my hands have. And to add to the mix I am awaiting an answer from the NYS retirement Dept. I worked for the city I live in and was "eligible to apply" for disability retirement...my poor attorney and you poor folks who have to read my craziness, sorry!!

I tried going to that web page you gave me and it said that it was unavailable, under construction~ have no clue what that was all about, but then again, it could be me messing things up as usual.

Thank you again.

Live, Laugh, Love ~
 
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#4
i'm not sure why the link won't work.
if you use the search the WCB in upper left of their site for disability classifications it'll come up.

if you've had a non-scheduled rating you can request a lump sum of the remaining weeks by filing a c-21 with the board.
http://www.wcb.state.ny.us/content/main/forms/c21.pdf

there is also a glossary available to help you with various terms
http://www.wcb.state.ny.us/content/main/...ossary.jsp

you can also contact the board directly for more detailed help or use the advocate:
http://www.wcb.state.ny.us/content/main/...InjWrk.pdf
http://www.wcb.state.ny.us/content/main/Contact.jsp
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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