Schedule Loss of Use - Stipulation Attachment - New York

Schedule Loss of Use - Stipulation Attachment - New York

Schedule Loss of Use - Stipulation Attachment is a legal document that was released by the New York State Workers' Compensation Board - a government authority operating within New York.

FAQ

Q: What is Schedule Loss of Use?
A: Schedule Loss of Use is a type of workers' compensation benefit.

Q: What is a Stipulation Attachment?
A: A Stipulation Attachment is a document that outlines the terms and conditions of a settlement agreement.

Q: What does the Schedule Loss of Use - Stipulation Attachment cover in New York?
A: The Schedule Loss of Use - Stipulation Attachment in New York covers the compensation for permanent impairments or disabilities suffered by an injured worker.

Q: What information is included in a Schedule Loss of Use - Stipulation Attachment?
A: A Schedule Loss of Use - Stipulation Attachment includes details about the injured worker's impairment, the percentage of disability, and the amount of compensation.

Q: Who is eligible for Schedule Loss of Use benefits?
A: Injured workers who have suffered a permanent impairment or disability are eligible for Schedule Loss of Use benefits.

Q: How is the percentage of disability determined?
A: The percentage of disability is determined by a medical evaluation conducted by a qualified physician.

Q: What should I do if I disagree with the percentage of disability determined?
A: If you disagree with the percentage of disability determined, you may request a hearing to present your case.

Q: Can I receive Schedule Loss of Use benefits while still working?
A: Yes, you can receive Schedule Loss of Use benefits even if you are still working.

Q: How long do Schedule Loss of Use benefits last?
A: The duration of Schedule Loss of Use benefits depends on the severity of the impairment and is determined by a schedule set by the Workers' Compensation Board.

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Form Details:

  • The latest edition currently provided by the New York State Workers' Compensation Board;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.

Download Schedule Loss of Use - Stipulation Attachment - New York

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