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You have been working with your attorney on a settlement of your Schedule Loss of Use (SLU) — referring to the injury to one or more of your limbs, such as to your hand, arm, or leg. You also injured another area, such as your back, neck or head, or you have a mental injury. Because of the circumstances of your case, your attorney has asked you to fill out a Schedule Loss of Use (SLU) Stipulation Attachment. This set of frequently asked questions and related definitions are designed to help you understand what you are being asked, and why.

Note: Since the most typical system injury is to the back or neck, the other injury will be referred to as ‘back or neck injury’ throughout this FAQ.

  1. Why am I being asked to fill out an SLU Stipulation Attachment?

    You are being asked to fill out an SLU Stipulation Attachment because you had an accident that caused a limb injury and a back or neck injury. You and your attorney have reached an agreement with the employer’s insurance carrier to pay you a sum of money for your limb injury (an SLU award), but the NYS Workers’ Compensation Board (Board) wants to make sure you understand fully what the impact is to the back or neck injury you had, and what could happen in the future if those conditions worsen.

  2. Why do you ask other medical questions?

    Your file has medical reports that say you have a permanent injury to your limb(s). However, the Board also needs to understand the nature of your back or neck injury. For that injury, your medical reports could be saying one of three things. Those three possibilities are: a) they say nothing about whether you have a permanent disability in those sites; b) they say that you have no permanent disability in those sites; or c) they say that you do have a permanent disability in those sites. Let’s look at each of these possible situations and what it means in terms of completing the SLU Stipulation Attachment:

    1. What if the medical reports say nothing about whether I have a permanent disability to my back or neck?

      If that’s the case, you need to answer the questions in the SLU Stipulation Attachment.

    2. What if the medical reports say that my back or neck is not permanently disabled?

      If that’s the case, your attorney can submit the Stipulation without needing this SLU Stipulation Attachment.

    3. What if at least one of the medical reports say that I do have a permanent disability to my back or neck?

      If that’s the case, it is important to understand Question 5 on the SLU Stipulation Attachment. Even with an opinion of permanent disability to your back or neck, the stipulation can still go forward on the SLU if the back or neck injury isn’t currently having a big effect on your life. That is why the three questions as part of Question 5 ask you whether you’ve recently had surgery, or are actively treating for the back or neck injury, or if the back or neck injury is affecting your ability to work. If you answer YES to any of these questions, and you choose to go forward with the Stipulation, your attorney should clearly explain the potential consequences to your ability to receive future benefits for that permanent disability to your back or neck.

  3. What if I was recently treated for my back or neck injury or it is affecting my ability to work? Does this matter?

    Yes. If your doctor has been treating your back or neck injury, and/or your injury has been affecting your ability to work, that would mean that your back or neck injury is not “quiescent” (see the definition below), and you are more likely to lose time from work, perhaps for a long period of time. You would answer Question 4 by checking the ‘No’ box, and providing an explanation of your situation. The Board will then set a hearing before a law judge, who will evaluate the evidence in your case, and make a decision about permanency.

  4. What happens if my back or neck injury worsens in the future?

    If your back or neck condition worsens in the future and you begin to lose time from work, you will not be allowed any additional wage replacement benefits until you have used up all of the “credit” (see the definition below) or value of the limb injury award you are being paid now.

  5. How does the credit work? Please give me an example.

    Here is an example of how the credit would work:

    Ms. Doe was injured on January 10, 2016, and hurt her right arm and low back. Both injuries were established as work related. Ms. Doe lost two weeks from work after the accident related to her right arm injury, but then fully returned to work without restrictions. She has lost no time from her back injury, but it acts up every so often. Ms. Doe’s doctor evaluated her for permanency on March 1, 2018, and found her to have a 40% SLU to the right arm, but did not say anything about whether she had permanency from her low back injury. Ms. Doe’s attorney and the insurance carrier for the employer reached an agreement to stipulate that she has a 40% SLU to the right arm. The fully signed Stipulation, and SLU Stipulation Attachment, were sent to the Board for review and the Stipulation was approved. Based on her wages before the injury, and deducting the two weeks of lost time she was previously paid for, Ms. Doe received an SLU award of $100,000.

    Then, two years later, Ms. Doe’s back problems intensify, and she begins receiving treatment for her lower back, eventually resulting in back surgery. Unfortunately, her back doesn’t recover enough to allow her to go back to work for three years, and she is totally disabled. Let’s say that her maximum rate (also known as the total rate) of compensation was $700 per week. In order for Ms. Doe to receive additional compensation for her lower back injury, the $100,000 she received for the SLU would be used as the source of any lost time, $700 at a time. The Board would divide $100,000 by $700, which gives us approximately 143. This number represents the number of weeks of lost time (at the total rate) before the workers’ compensation insurance carrier would have to pay for any new or additional lost time. In this case, 2.75 years of lost time must be subtracted (or credited) to the employer before Ms. Doe could receive any new money.

    To summarize, when we talk about the ‘credit’, we mean that the dollars received from the SLU award would be the same source of money if the injured worker lost any future time from the back or neck injury that happened in the same accident, and that it could be a long time (2.75 years in the example) before the injured worker would receive any new money.

  6. What does it mean in Question 6 when it says: “the Board will enter a finding of no further causally related disability at this time with respect to your established non-schedule sites or conditions”?

    This means that at this point in time, you are not losing any time from work as a result of your back or neck injury.

  7. Why does the SLU Stipulation Attachment ask if I understand that “this form is not for settlement or final resolution of your claim, which could only be done by Section 32 Waiver Agreement”?

    We want to make sure you know that this is not a Section 32 Waiver Agreement. In a Section 32 Waiver Agreement, whatever you are agreeing to can never be reopened. In a stipulation, there is a way for a future issue to be reopened and resolved if something comes up down the road. For example, if you had an accident and eventually entered into a Section 32 Waiver Agreement that paid you money for your back and shoulder injuries, and closed both the indemnity and medical issues, once it became final it could never be reopened, no matter what. In contrast, a Stipulation that is approved by the Board, that paid you a sum of money for your shoulder injury as an SLU, and said that currently there are no problems with your back, can be reopened for any issues in the future, and you continue to receive medical care.



The term ‘established’ means that the particular body part or condition is officially considered part of your claim. You receive medical treatment for that injury, and are entitled to money for losses in work time or, if you are still working, reductions in your earnings. For example, if you hurt your right arm and your back or neck, the Board would say that you have an established right arm and back or neck claim, which means that you have both established SLU and non-SLU body parts in your claim.

Non-Schedule Body Site(s) and Condition(s)

This term is used to describe the body parts or conditions that are not specifically tied to your limb injury. Most commonly, these are injuries to your back, neck, mental injuries, or other types of medical conditions or chronic problems, but will be referred to as ‘back or neck’ injury, as in the FAQ. When you have permanency from your back or neck injuries (or other non-schedule injuries), payments are not based on a ‘schedule’, as there would be for your limb injury. Payments are based on time you lost from work or a reduction in wages as a result of your back or neck injury. When this term is used for a stipulation, it is referring to the non-schedule body part injury that happened in the same accident as the injury to your limb(s), in this case your back or neck.

Schedule Loss of Use (SLU) Award

A Schedule Loss of Use award is a payment of money for the loss of use of a particular limb or part of a limb. These awards are for injuries to arms, legs, feet, hands, toes, fingers, as well as loss of vision or hearing.


The term ‘quiescent’ means that your injury is not something that you are actively receiving treatment for. It does not mean that you do not have any concerns or symptoms, just that you are not regularly receiving treatment for it. That’s why Question 4 asks if you are actively treating now for the injury. That’s why Question 4 also asks if your doctor is advising you now to have surgery. It is important to note that if your doctor does recommend surgery, but there’s a medical reason that you can’t have surgery, that won’t prevent the stipulation from being approved.


The term ‘credit’ refers to what would happen after you receive your Schedule Loss of Use award if you started to lose time, or suffer a reduction in wages, from your back or neck injury that was injured in the same accident as your limb injury. If, after your SLU is paid for your limb injury, you suffer lost time for your back or neck injury from the same accident, you would not receive any new money until the full value (or credit) of the SLU award was applied to any lost time you have.

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