Workers’ Compensation Benefits When an Amputation Occurs

Posted on Friday, November 22nd, 2019 at 1:31 pm    

Workers who lose a limb due to any type of accident are entitled to unique workers’ compensation benefits because of their injuries. The benefits may be unique because the medical needs are different than most other injuries and because many workers may be entitled to scheduled pay benefits for a specific number of weeks – based on the specific body part(s) that were amputated. Whether the claim for those benefits becomes a significant part of the claim really depends on whether the injured worker is able to return to work at the same or greater pay than pre-injury. 

Medical expenses

Injured employees who suffer a workplace accident are entitled to have their medical bills paid. This includes the initial surgery to try to save as much as the limb or body part as possible, to leave the surrounding body parts as healthy as possible, and to help the worker be able to have a good fitting prosthetic. 

For most amputees (those who lose an arm or a leg), being fit for a prosthetic device and learning how to use the device requires a lot of medical treatments and care. Many victims may need to have their prosthetic device replaced every few years. Newer better devices may be available with time. The cost of a prosthetic device can run $5,000 to $50,000 according to Hospital for Special Surgery. The insurance company for the employer should pay all the reasonable costs so that you can regain as much function as possible.

Workers who lose a limb or a body part usually require physical therapy, occupational therapy, and other help so that they can return to their job or be in a position to learn a new job. Many workers who suffer an amputation also need psychological counseling to help them adjust to living a life without an arm, leg, hand, foot, or other body part. In addition, many workers need pain management treatment. They may need addition medical help if infections occur.

In addition to prosthetics, there are new develops such as artificial joints and computerized anatomy that may help a worker restore function to a limb or body part that was severed.

Joe Miller and the Work Injury Center have represented, and continue to represent injured workers who have suffered an amputation injury. 

Work loss benefits

Like other workers, employees who have a part of their anatomy amputated, are entitled to 2/3rds \ of their pre-injury average weekly wage during the healing process and so long as they are unable to return to work. 

  • Some workers can return to work after they have completed their medical treatment for the amputation. 
  • Many workers, especially if they lose both arms, both arms, or multiple body parts have a permanent total disability and can never return to work. This means the injured worker would be able to claim lifetime benefits, not limited to the usual 500-week limit. 
  • Many workers are able to return to work but to different jobs. For these workers, employer insurance companies may choose to pay for the cost of vocational rehabilitation.

Once a worker has reached the point of maximum medical improvement (no further medical treatment will improve their overall health), an evaluation is made as to the type of disability they have – a total or partial disability. 

  • Workers with a permanent total disability who can’t return to work are entitled to 2/3rds of their average weekly wages for the rest of their lives.  In Virginia, this means significant permanent impairment to two or more limbs. 
  • Workers with a partial permanent disability who can return to work are entitled to 2/3rds of the difference between their pay before the accident and their pay in a new job.
  • Workers who have reached maximum medical improvement, and who have returned to work at either a lesser paying job or a job paying the same or more as pre-injury may qualify for the following benefits according to the North Carolina workers’ compensation law – Section NCGS 97-31. Virginia has a similar section at VA Code Sec 65.2-503
  • Note that these figures represent TOTAL loss, i.e. the maximum payments based on the total loss of the limb mentioned. If there is not a total loss, then you multiply the weeks mentioned by the percentage loss given by the physician. 
  • Note that these amounts of payments DO NOT increase the 500-week limit. So that if the injured worker is unable to return to work, and is receiving temporary total disability checks, he or she may not also receive these payments. Accordingly, these weeks generally only become relevant if the injured worker has returned to work: 
  1. For the loss of a thumb, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 75 weeks.
  2. For the loss of a first finger, commonly called the index finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 45 weeks.
  3. For the loss of a second finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 40 weeks.
  4. For the loss of a third finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 25 weeks.
  5. For the loss of a fourth finger, commonly called the little finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 20 weeks
  6. The loss of the first phalange of the thumb or any finger shall be considered to be equal to the loss of one half of such thumb or finger, and the compensation shall be for one half of the periods of time above specified.
  7. The loss of more than one phalange shall be considered the loss of the entire finger or thumb: Provided, however, that in no case shall the amount received for more than one finger exceed the amount provided in this schedule for the loss of a hand.
  8. For the loss of a great toe, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 35 weeks.
  9. For the loss of one of the toes other than a great toe, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 10 weeks.
  10. The loss of the first phalange of any toe shall be considered to be equal to the loss of one half of such toe, and the compensation shall be for one half of the periods of time above specified.
  11. The loss of more than one phalange shall be considered as the loss of the entire toe.
  12. For the loss of a hand, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 200 weeks.
  13. For the loss of an arm, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 240 weeks.
  14. For the loss of a foot, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 144 weeks.
  15. For the loss of a leg, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 200 weeks.

North Carolina and Virginia Workers’ Compensation Lawyer Joe Miller Esq. has earned the high respect of former clients and the legal community for his ability to win and settle work injury cases. He understands how to counter many of the arguments defense lawyers assert to try to minimize your claim. He works with orthopedists, neurosurgeons, pain management doctors, and other medical professionals to assess and document the severity of your amputation. For help now, contact attorney Joe Miller at 888-694-1671 or fill out my contact form to make an appointment.