Reviewed by Laurence P. Banville, Esq.How New York calculates what you are paid
New York workers’ compensation is a no-fault system, so you do not need to prove your employer did anything wrong. Workers’ Compensation Law Your wage-replacement check is set by a formula, not by a jury, and it has three main parts for a shoulder claim:
- Lost-wage benefits. You receive two-thirds of your average weekly wage, multiplied by your percentage of disability, up to the state maximum in effect on your date of injury.
- Medical treatment. Authorized care for the shoulder, including surgery, physical therapy, injections, and diagnostics, is covered at no cost to you.
- A permanency award. Once you reach maximum medical improvement, you may receive a scheduled loss of use award for lasting damage to the arm or shoulder.
The scheduled loss of use award for a shoulder
The shoulder is part of the arm under New York’s schedule, and a full arm is valued at 312 weeks of benefits. After you stabilize, your doctor and the insurer’s doctor assign a percentage of permanent loss of use of the arm. That percentage is multiplied by 312 weeks and by two-thirds of your average weekly wage.
For example, a 20 percent loss of use of the arm equals roughly 62 weeks of benefits. The dollar figure depends entirely on your wage and your loss-of-use percentage, so two people with the same surgery can receive very different awards. Any wage-replacement benefits already paid for that body part are typically credited against the schedule award.
What raises or lowers your payout
Several factors drive the final number, and outcomes vary from claim to claim:
- Your average weekly wage in the year before the injury.
- The final loss-of-use percentage, which often hinges on range of motion, strength, and surgical findings.
- Whether you needed surgery such as a rotator cuff repair or labral repair.
- How long you were out of work and your degree of disability during that time.
- Whether the injury is classified as a permanent partial or permanent total disability.
When a separate lawsuit may add to your recovery
Workers’ compensation does not pay for pain and suffering, and it does not let you sue your own employer. If someone other than your employer caused the injury, such as a negligent contractor, a property owner, or a defective equipment manufacturer, you may also bring a third-party personal injury lawsuit. CPLR §214 That separate case can pursue full damages, including pain and suffering, which comp alone cannot provide.
To understand how a comp claim and a lawsuit can work together, see the related guides below and the main Workers’ Compensation hub. Every claim is fact-specific, and prior results do not guarantee future outcomes.
Frequently asked questions
Does workers comp pay a set dollar amount for a shoulder injury in New York?
No. There is no flat payout. Your benefits are calculated from two-thirds of your average weekly wage, your degree of disability, and a permanency award based on your percentage of loss of use of the arm. Because of this, two similar injuries can result in very different amounts.
How is the shoulder valued under New York's schedule?
The shoulder is treated as part of the arm, and a full arm is worth 312 weeks of benefits. Your doctor assigns a percentage of permanent loss of use, which is multiplied by 312 weeks and by two-thirds of your average weekly wage to set the scheduled loss of use award.
Does workers comp cover my shoulder surgery and therapy?
Yes. Authorized medical treatment for a work-related shoulder injury, including surgery, physical therapy, injections, and imaging, is covered at no cost to you when handled through the comp system.
Can I sue in addition to collecting workers comp?
You generally cannot sue your own employer, but if a third party such as a contractor, property owner, or equipment maker caused the injury, you may file a separate personal injury lawsuit. That case can seek pain and suffering damages that workers' compensation does not pay.
When do I get the permanency award?
The scheduled loss of use award is determined after you reach maximum medical improvement, meaning your shoulder has healed as much as it is expected to. At that point the loss-of-use percentage is set and the award is calculated.