Reopening And Reclassification After A Finding of Permanent Partial Disability
In Sanchez v. Jacobi Medical Center, the injured worker was classified as having a permanent partial disability (“PPD”) in 2012 with a weekly benefit rate of $212.56 per week and a benefit period of 300 weeks. After that, he had two spine surgeries one in 2014 and one in 2015. The WCL Judge awarded him fifteen months of temporary total disability following those surgeries and held that those months did not count against the 300 weeks of PPD benefits.
The City appealed, and the Workers’ Compensation Board found that after a PPD classification:
(1) The injured worker’s benefit rate could not be increased following a later surgery;
(2) The number of PPD benefit weeks would remain unchanged; and
(3) Any application for reclassification at a higher level of disability had to be made before the PPD benefit weeks expired.
Grey & Grey appealed this decision to the Appellate Division, Third Department, which reversed the Board and held that:
(1) An injured worker can have a change in condition after a PPD classification;
(2) If the evidence shows that the injured worker is totally disabled, the Board must award compensation for the period of total disability;
(3) The weeks of temporary total disability do NOT count against the period of PPD benefits; and
(4) The law allows the injured worker to seek reclassification “at any time,” and the Board must provide him or her with an opportunity to do so.
The decision in Sanchez was crucial to preserving the right of injured workers to apply for and receive the benefits provided by the Workers’ Compensation Law.