At Sawers & Sackel, we focus exclusively on representing injured workers in Buffalo, New York. Since these questions come up frequently, we’ve put together this guide to explain how the one-year rule works and when a workers’ compensation claim may be reopened.
If you’ve had surgery for a serious extremity injury, like a shoulder dislocation, you may have heard that you have to wait about a year before your permanency can be evaluated. That’s what’s commonly referred to as the “one-year rule.”
Before a Schedule Loss of Use (SLU) award can be made, an injured worker must first reach Maximum Medical Improvement (MMI). In New York workers’ compensation cases, MMI means your condition has recovered as much as expected and further treatment is not likely to result in additional improvement.
For certain extremity injuries, the New York Workers’ Compensation Board’s Impairment Guidelines recommend waiting at least one year after corrective surgery before the permanency evaluation takes place. The purpose is to give your condition enough time to stabilize so the evaluation reflects your lasting level of function rather than your early recovery.
The one-year rule applies only to certain SLU evaluations involving extremities. It doesn’t apply to every New York workers’ compensation claim.
You may be able to reopen a workers’ compensation case if objective medical evidence shows that your permanent anatomical or functional loss has increased since your original SLU award. Your doctor must document the change by comparing your current condition to the original permanency evaluation. That may include decreased range of motion, reduced grip strength, or other measurable findings showing a greater permanent loss of function.
The New York Workers’ Compensation Board reviews the updated medical evidence to determine whether it supports an increased SLU award. Whether a case qualifies for reopening depends on the medical findings, the applicable law, and the facts of the individual claim.
If you settled your workers’ compensation claim through a Section 32 Waiver Agreement, different rules apply. A Section 32 is a settlement that closes some or all parts of a claim. Once the Board approves the agreement, the issues covered by the settlement are generally final and usually can’t be reopened.
The exception is if a case was finalized under Section 32 for indemnity rights only, but your medical rights remain open and in place. If so, you are entitled to reopen your case with medical evidence on issues of causally related medical treatment, but no further awards for lost time or permanency are due.
Determining whether a workers’ compensation case qualifies for reopening starts with reviewing the original SLU award and comparing your current medical findings to the original permanency evaluation. An attorney can determine whether the medical evidence supports an increased award and help gather the documentation needed to present your claim.
Sawers & Sackel focuses exclusively on representing injured workers in Buffalo and throughout New York. If you believe your permanent condition has worsened since your original SLU award, fill out our contact form or call 716-202-2367 to discuss your case.
]]>At Sawers & Sackel, we help injured workers in Buffalo, New York, understand their rights under the workers’ compensation system. One of the most common misconceptions is that returning to work means the claim is over. The fact that you’re working again doesn’t always mean your workers’ compensation case is over.
Permanency benefits are workers’ compensation payments for workers who are left with a permanent loss of function after a work injury. In New York, these benefits are often paid through a Schedule Loss of Use (SLU) award for qualifying injuries.
No. Returning to work doesn’t automatically mean your workers’ compensation claim is over.
Many workers assume that going back to work means they can no longer receive additional benefits. That’s not necessarily true. In New York, permanency benefits are based on the lasting effects of the injury, not simply on whether you’ve returned to a job.
In fact, some workers return to the same position with the same employer and still qualify for permanency benefits. What matters is the permanent loss of function caused by the injury, not whether you’ve gone back to work.
Sometimes it’s obvious. Other times, it’s the kind of thing you adapt to without realizing how much the injury still affects you.
You may find yourself:
Many workers assume these changes are simply part of getting older or something they have to live with after an injury. But when those limitations remain long after treatment has ended, they may represent a permanent loss of function.
Getting back to work is often viewed as the end of the recovery process. For many workers, however, it’s simply the point where they begin noticing what hasn’t returned.
That’s why it’s important to understand that returning to work and receiving permanency benefits aren’t mutually exclusive. A workers’ compensation claim doesn’t always end when you return to your job, and the long-term effects of an injury can remain relevant long after you’re back at work.
If you’re unsure how your recovery may affect the outcome of your case, Sawers & Sackel can help. To schedule a meeting, contact our office or call 716-202-2367.
]]>At Sawers & Sackel, we help injured workers throughout Buffalo and Western New York with workers’ compensation claims involving permanency and extremity injuries. Understanding how permanency evaluations work can help you determine whether your current condition is being accurately reflected in your claim.
At some point during a workers’ compensation claim, your doctor may perform a permanency evaluation. This assessment is used to determine whether a work injury has resulted in any lasting loss of function and, if so, how significant that loss is.
These evaluations often take place after you’ve completed treatment or your condition has become more stable. Rather than focusing on your symptoms at their worst, the evaluation looks at the limitations that remain after recovery.
In New York, permanency evaluations are especially important for certain extremity injuries. Injuries involving the shoulder, arm, hand, leg, foot, hearing, or vision may qualify for a Schedule Loss of Use (SLU) award. The findings from the evaluation can play an important role in how that award is calculated.
Even after a permanency evaluation is completed, the story doesn’t always end there.
Not every injury follows the path doctors initially expect. While some workers recover and move on, others continue to experience problems long after a permanency evaluation has been completed. You may start questioning your original rating if:
When workers begin noticing these kinds of changes, it’s natural to wonder whether the original permanency evaluation captured the full extent of the injury.
When an injury turns out to be more serious than originally believed, a treating doctor may perform a new evaluation and conclude that the original permanency rating no longer reflects the extent of the injury.
The insurance carrier may agree with that assessment, or it may rely on its own medical examiner and dispute the new findings.
When there are competing opinions, the medical evidence becomes especially important. If the updated evaluation shows a greater permanent loss than what was originally documented, it can affect the value of the SLU award.
If your injury turns out to be more serious than originally believed, the permanency evaluation may not tell the whole story.
When questions come up about a permanency rating, the answers are often found in the medical evidence and the details of the claim itself. At Sawers & Sackel, workers’ compensation is all we do. If you have questions about your permanency rating or claim, schedule a meeting or call 716-202-2367.
]]>At Sawers & Sackel, we’ve helped injured workers in Buffalo, New York, navigate permanency issues tied to serious extremity injuries and chronic pain after surgery. Below, we explain when ongoing knee pain may qualify as a permanent disability under New York workers’ compensation law and what can make these claims difficult to prove.
Some knee injuries improve with time, even after a difficult recovery. Others leave lasting problems that continue long after surgery and physical therapy end. If your recovery has stalled and daily movement still causes pain, your injury may no longer be considered temporary.
Common signs of a possible permanent knee injury include:
Many workers first notice the impact at work. Tasks that once felt routine may now feel unsafe, slower, or physically exhausting. The claim may move into a permanency evaluation which should occur one year post injury or one year post your last surgery, whichever is later.
Under New York workers’ compensation law, doctors eventually decide whether you’ve reached maximum medical improvement, meaning further recovery is unlikely. Once that happens, the claim may move into a permanency evaluation.
For knee injuries, this often involves a permanent partial disability finding or a schedule loss of use (SLU) evaluation. An SLU rating looks at the lasting loss of function in the knee, including mobility, strength, and overall use of the joint.
Insurance carriers don’t automatically accept that chronic knee pain qualifies as a permanent disability. Even after surgery, they may argue that you can still return to work, that your condition should improve over time, or even that your current symptoms aren’t connected to the original workplace injury.
Many disputes come from independent medical examinations, known as IMEs. The insurance company doctor may say your knee has healed enough to return to work or assign a lower impairment rating than your treating doctor.
For this reason, strong medical documentation can make a major difference in permanency claims. Records that clearly show ongoing pain, mobility limitations, work restrictions, and failed recovery progress can help support the argument that the injury has lasting consequences.
Persistent knee pain after surgery can sometimes qualify as a permanent disability under New York workers’ compensation law, especially when the injury continues to affect your ability to work. Every case depends on the medical evidence and the lasting impact on your mobility and job duties.
You shouldn’t assume this is something you simply have to live with. To discuss workers’ compensation benefits for permanent knee injuries, contact Sawers & Sackel in Buffalo, New York, at 716-202-2367.
]]>At Sawers & Sackel, we support injured workers in Buffalo, New York with workers’ compensation claims involving permanency and extremity injuries. Below, we explain when reopening a claim becomes an issue and how it can affect a permanent injury case.
A workers’ compensation claim is usually reopened when the injury has clearly gotten worse after the case was resolved. For some workers, that means they’re experienced more pain, reduced mobility, or now need surgical intervention.
In other cases, updated medical testing shows the permanent damage is more serious than originally believed. This is common in permanency claims involving extremity injuries, where loss of use can become more severe over time.
In New York, there are time limits for reopening a workers’ compensation claim. Under the 18-and-8 rule, the case usually can’t be reopened more than 18 years after the injury or 8 years after the last compensation payment. After the last compensation payment for purposes of claiming further indemnity/monetary awards, but can be reopened at any time for payment of casually related medical treatment.
Permanency claims involving extremity injuries can become more serious over time. A shoulder, knee, hand, or foot injury may lead to more limited movement years after the original case was resolved.
When that happens, the Schedule Loss of Use (SLU) percentage tied to the injury can also increase. In New York, a higher percentage can lead to additional compensation because the award is based on the level of permanent loss.
This works differently from injuries involving the back, neck, or head. Those claims are usually evaluated based on how the injury affects long-term earning ability rather than a fixed loss percentage.
Insurance companies often challenge these cases when updated evaluations show a greater loss than what was originally assigned. Because of that, current medical findings can play a major role when reopening the claim.
Many injured workers assume their case is over once payments stop or a decision is issued. But a worsening extremity injury or updated medical findings can increase the value of the case years later, which is why doctors may need to reevaluate the injury over time.
At Sawers & Sackel, we help injured workers in Buffalo, New York with workers’ compensation claims involving permanency and extremity injuries. If your condition has worsened since your case was resolved, contact us or call 716-202-2367 to discuss your situation. Our consultations are free, and our cases are handled on a contingency fee basis.
]]>At Sawers & Sackel, we help injured workers in Western New York with permanency claims. Below, we explain how to recognize when your case may involve permanency and what that can mean for your claim.
It’s frustrating to realize your pain isn’t going away and that this may be your new normal. But that doesn’t always mean your case is finished. In a workers’ compensation claim, if your condition stops improving, it may be treated as permanent.
You may be at that point if:
When that happens, your case may need to be evaluated differently.
If your injury is found to be permanent, your case may qualify for a Schedule Loss of Use, often called an SLU award. In New York, that applies to certain body parts and functions, including the arms, legs, hands, feet, fingers, toes, hearing, vision, and certain facial disfigurement.
This happens after you’ve reached maximum medical improvement (MMI), meaning your condition has improved as much as it’s expected to. At that point, a medical provider evaluates the affected area, assigns a percentage of loss, and that percentage is used to calculate the award.
This type of compensation is based on the permanent loss of function, not just the fact that you were injured. You can qualify even if you’ve returned to work, since it’s based on what you’ve permanently lost, not just time missed.
If the injury involves a part of the body that is not on this list, such as the back, neck, brain, or lungs, the claim is handled differently and may not fall under this type of award.
If you’re still dealing with symptoms and not seeing improvement, it’s worth taking a closer look at where your case stands. Many workers assume things will resolve on their own or that what they’re experiencing is just part of the process. But once recovery levels off, the way your case is handled can change, and that’s not always obvious unless someone points it out.
At this stage, having your condition properly evaluated is essential. The timing of that evaluation and how your condition is documented can affect how your claim moves forward. Contact Sawers & Sackel, we help injured workers in Buffalo and Western New York, including the Southern Tier and Rochester, with workers’ compensation claims, with a strong focus on permanency and extremity injuries.
If you’re not sure where your case stands, you can call 716-202-2367 to discuss your case.
]]>At Sawers & Sackel, we help workers across Western New York handle hearing loss cases and understand how permanent damage impacts their benefits. Below, we explain how this type of injury develops and what you can do next.
A single loud event, like an explosion, can sometimes cause work-related hearing loss. But more often it builds over time from repeated exposure.
That kind of exposure is common in jobs where you’re around machinery, tools, or just constant loud noise for long periods of time. Even if the noise doesn’t immediately seem that bad, the effect adds up. Over time, that repeated strain can lead to lasting damage.
Early signs of hearing damage can include:
Because these symptoms can come and go, many workers assume it’s just part of the job.
If your hearing isn’t improving over time, it’s something you should take seriously. You may notice:
If these issues continue without improvement, it may be a sign of permanent damage. In many cases, these symptoms improve within a day or two. When they don’t, the risk of lasting damage becomes higher.
If your hearing damage is not going away, your claim may be treated differently. Long-term or permanent hearing loss can affect the type of benefits available to you.
In many cases, your hearing will need to be tested after you’ve been away from the noise long enough to measure the damage. That testing helps determine how much hearing has been lost and whether it is permanent.
From there, your claim comes down to proof. You need medical records from an authorized provider that connect your hearing loss to your job. That information is what determines how your claim is evaluated and what compensation may be available.
These claims are often challenged, especially when the damage developed over time. Insurance companies may question what caused the loss or when it started, which is why clear medical evidence matters.
If your hearing isn’t improving, act early. Report your symptoms and get evaluated by an authorized provider so there’s a clear medical record. The sooner it’s documented, the easier it is to connect it to your job.
These claims are often challenged, especially when the damage developed over time. Insurance companies may question what caused it or when it started, so having the right medical evidence in place can make a difference.
At Sawers & Sackel, we handle hearing loss cases across Buffalo and Western New York, including the Southern Tier and Rochester. If your hearing is not improving or your claim is being questioned, you can contact our office to discuss your situation. We offer free consultations and work on a contingent-fee basis.
]]>Your health is the main priority after a spinal injury. Spinal injuries are serious, but they do not always show symptoms right away. As a result, it is critical that you be examined by a doctor as soon as possible. If you can move, go to the nearest emergency room. If you are unable to move, do not try to or ask your co-workers to help you move. Instead, call emergency services.
You can see any doctor of your choosing while on workers’ compensation. If your employer has a preferred provider organization (PPO), you must see a doctor within that network for the first 30 days. Any doctor you see must also be authorized by the Workers’ Compensation Board.
Notify your employer, in writing, about the accident that resulted in injury within 30 days. Failing to do this can result in a forfeiture of your benefits. Include details of where, when, and how the injury occurred and keep a copy of the notice for your own records.
Unlike in other states, employees in New York must file a claim with the Workers’ Compensation Board. The fastest processing is done online, but you can also mail in your application. Attach any medical records and other documentation that support your claim. While you have two years to file your claim, it is recommended that you file as soon as possible.
Thorough documentation provides a strong foundation for workers’ compensation claims. Take pictures and video footage of the accident scene, any equipment involved, and pertinent details, such as worn or outdated safety gear. Also, obtain the names and contact information of any witnesses to the accident.
Retain copies of all medical bills, diagnostic reports, prescription receipts, and any communication with your employer or the Workers’ Compensation Board. Make sure to follow all medical recommendations and advice, as this can help establish the full extent of your injury.
The workers’ compensation system in New York can be complex, and going through it on your own can result in mistakes that forfeit your right to benefits. At Sawers & Sackel, our workers’ compensation lawyers can guide you through it, help you avoid mistakes, and work hard to obtain the full benefits you need. Contact us online or call us today at 716-456-8962.
]]>If you have been injured while on the job in New York, seeking medical treatment is of the utmost importance. It is the only way to protect your safety and well-being. However, injured workers often have questions regarding the physician they should see. So, if you have been hurt, can you see your own doctor for treatment?
Yes. While many other states place restrictions on the doctors that injured workers can see after a workplace accident, this is not the case in New York. Generally speaking, you can seek medical attention from any physician who accepts workers’ compensation payments. Although your employer’s insurance company cannot prohibit you from seeing a specific physician, they may also ask for a second opinion.
The insurance company also has the right to request an independent medical examination (IME). An IME can only be conducted once and may involve a physical exam as well as an evaluation of your medical records. You can record your IME and bring a witness to the exam.
You can search the provider database provided by the Workers’ Compensation Board to find a doctor to treat your injury. If you already have a doctor, you can ask them whether they accept workers’ compensation payments. If so, you can receive treatment from them. However, they must complete and file a “Doctor’s Initial Report” within 48 hours of your first visit. If they do not file this form, the insurance company may deny the payment.
Some states also prevent workers from changing doctors once treatment has begun. Or they limit how many times a person can change doctors. This is not necessarily true in New York, but there is a caveat. If your employer’s workers’ compensation insurance company has a preferred provider organization, you must see a doctor within that network for the first 30 days of your injury.
After the initial 30 days, you can see whichever doctor you prefer, even if that means changing doctors. You can also change doctors as often as you wish after the initial 30 days. Still, any physician you see for treatment must be authorized by the Workers’ Compensation Board.
It is common to have many questions when filing a workers’ compensation claim. At Sawers & Sackel, our Buffalo workers’ compensation lawyer can provide the answers and legal advice you need so you can move forward with confidence and obtain the benefits you need to recover from a workplace injury. Call 716-455-2416 or contact us online to schedule a consultation and to learn more about how we can help with your case.
]]>Before claiming compensation, you must first report the injury to your employer. While the law gives you 30 days to do this, you should inform your employer in writing as soon as possible after suffering an injury. Your employer then has ten days to report the accident and resulting injury to their insurance company.
After your employer has reported the injury to their insurance company, the insurer will review the claim. Often, it is the insurance company representing the employer that determines whether to accept your claim. However, the New York Workers’ Compensation Board can also decide whether or not you are eligible. Your employer’s insurance provider has 15 days to decide on your claim.
While you should file your claim as soon as possible, it is essential to note that state law only gives you a limited amount of time to file. If you do not file within two years of the accident, you will likely forfeit your right to receive any benefits at all.
Ideally, you will start receiving benefits after filing your claim. Under state law, you must begin receiving benefits no later than 18 days after sustaining the injury if the insurer or the Workers’ Compensation Board has determined you are eligible. Once you start receiving benefits, they will be paid bi-weekly. In some cases, such as if you have suffered a permanent disability, a lump sum payment may be possible.
If the insurance company or the Workers’ Compensation Board denies your claim, you have 30 days to appeal the decision. If you do not file your appeal with the Board within this time, you will likely lose your right to obtain any benefits at all. The appeals process is very complex, so it is essential to work with an attorney who can guide you through it.
After suffering a work injury, you need benefits as soon as possible. At Sawers & Sackel, our Buffalo workers’ compensation lawyer can help you navigate the process so no mistakes are made that could delay the benefits you need. Call us now at 716-455-2416 or contact us online to schedule a consultation with one of our experienced attorneys and to get the legal help you need.
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