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  • Sroi 04 - Workers' Compensation Board - New York State - Wcb Ny

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State of New York - Workers ' Compensation Board Subsequent Report of Injury Report Type (MTC) 04-Denial This paper contains information that has been provided electronically to the Board. Do not.

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Your doctor will assign a disability rating to each affected body part on a scale of zero (0) percent to 100 percent.

The report must include an examination of the injured body part, and state the percentage of functional use you have permanently lost in the body part you injured. For example, the report may state that you have 25% less function than you had before your injury. This is also called a schedule loss of use, or SLU.

What is a Schedule Loss of Use ( SLU ) award? A cash benefit that pays you for the loss of wage-earning capacity (as determined by the Workers' Compensation Board, with proper consideration of the Workers' Compensation law and the current Permanent Impairment Guidelines.)

Your average weekly wage (AWW) is based on your total gross earnings (not take-home pay) for the 52 weeks before the date of injury or illness, including overtime and other compensation. Your AWW is calculated by dividing your total gross earnings by 52.

The report [PDF] shows a downward trend in employers' overall workers' comp costs. The costs per $100 in covered wages decreased in every state between 2016 and 2020....The highest workers' comp rates by state jurisdiction are: Wyoming: $1.78. Alaska: $1.74. Hawaii: $1.69. Montana: $1.64. South Carolina: $1.55. Idaho: $1.47.

When Does A “Protracted Healing Period” Apply? New York defines the “normal healing period” for scheduled injuries. In cases where the claimant remained totally disabled for a period of time in excess of the established healing period, additional compensation payments are required.

How much is an SLU award? Your SLU award is determined by Workers' Compensation law (statute), which contains a schedule (list) of the maximum number of weeks of benefits you can receive ing to the body part you have permanently injured.

Under New York Workers' Comp law, a Schedule Loss of Use (SLU) award may be made when a claimant has reached maximum medical improvement and the claimant's body part(s) have a permanent loss of use as a result of their work-related injury.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232