A knee injury at work in New York is usually worth a permanency award, and the number attached to it is far less predictable than most injured workers assume. It does not come from the MRI, from the name of the operation, or from how much the knee hurts on a bad day. It comes from how far the knee bends and straightens when somebody measures it.
That single fact explains most of what goes wrong in these claims.
Your knee is paid as your leg
New York’s statutory schedule does not list a knee. Knee impairment is scheduled as loss of use of the leg, and the leg carries 288 weeks of benefits at total loss. Your award is a percentage of those 288 weeks, multiplied by your weekly compensation rate.
People searching for what a knee is “worth” often cannot find it anywhere, and conclude that knees are not covered. They are — they are simply valued through the leg.
How these awards are calculated, what comes off the top, and how they sit against a settlement are covered on our Schedule Loss of Use page. This page deals with what is particular to knees.
Flexion and extension decide it
Under the Board’s 2018 Impairment Guidelines, a knee evaluation measures two things: flexion, how far the knee bends, and extension, how fully it straightens. Where both are restricted, it is the greater of the two deficits that governs.
Those measurements are compared to your uninjured knee first. The Guidelines’ normal values are used only when the other knee cannot serve as a fair comparison, for example because it has its own old injury or arthritis. See how your other leg can become the measuring stick.
Extension is the one people underestimate. A knee that will not fully straighten is often more disabling in daily life than one that will not fully bend, and it is easy to describe your own knee as “pretty good” when the measurable restriction is the one you have quietly adapted to.
The practical consequence is the same as with any scheduled joint: when and how the measurement is taken matters more than anything else in the file.
If you had a knee replacement
Total knee replacement is treated specifically in the 2018 Guidelines. A replacement with a good outcome starts at 35 percent loss of use of the leg, with a good outcome defined by clinical thresholds — flexion beyond 105 degrees, extension within 10 degrees, minimal alignment or laxity problems and no chronic complications. Deficits beyond those thresholds are added to that starting figure.
So a replaced knee that works well still carries a substantial award. A replaced knee that did not go well carries more. It is worth knowing that before anyone tells you that a successful operation means there is nothing to claim.
If you had a meniscus repair, the rules changed in 2018
The 2018 Guidelines removed the special considerations that previously attached to meniscal tears, with or without surgery. Having had the tear, or the arthroscopy, no longer carries a value of its own.
This surprises people who were told years ago what a meniscus case was “worth” and have been carrying that figure around since. As with the shoulder, the award now follows the measured range of motion at maximum medical improvement rather than the operative report.
If you were out of work a long time: the protracted healing period
A schedule award is a fixed number of weeks, and payments already made to you for the same injury are credited against it. After a long period out of work, that can leave a disappointingly small balance — which is where people decide the award was meaningless.
The protracted healing period provision exists for exactly this, and it is one of the most commonly missed elements of a knee claim.
New York sets a normal healing period for each scheduled member. For the leg — which is how a knee is valued — it is 40 weeks, the longest of any member. Where temporary total disability ran beyond that, the excess weeks are added to the number of weeks the schedule award runs for.
Knee claims reach this more often than most, because reconstruction and replacement carry long recoveries and legs are slow to rehabilitate. A serious knee injury that kept someone at total disability well past ten months is not unusual, and those additional weeks should not vanish into the credit.
Note that the provision turns on temporary total disability rather than temporary partial, so how your periods were classified while you were recovering affects the final number.
Four things that cost knee claimants money
1. A C-4.3 that is not properly completed
Permanency is decided on Form C-4.3, the Doctor’s Report of MMI/Permanent Impairment, together with the attachment recording the actual measurements. A form that comes back without the range-of-motion figures, without a maximum medical improvement date, or without addressing both flexion and extension is the single most common avoidable problem in these cases.
It is not a formality. If your treating doctor’s report is incomplete, the carrier’s examiner may end up being the only party who properly documented your knee.
2. The IME’s measurements
The carrier sends you to its own examiner, who takes their own readings in a short appointment. Those readings frequently differ from your treating physician’s, and a modest difference in degrees translates into a real difference across a 288-week member.
Competing opinions on the degree of loss are resolved before a judge, not by default. Our page on independent medical examinations explains what that appointment actually is.
3. The other knee
This is the one specific to legs. Months of favoring an injured knee loads the opposite one, and a genuine consequential injury to the good knee is common enough that it should be asked about in every case. It is a separate scheduled member with its own potential award.
Hips and the lower back can be affected by an altered gait in the same way. It has to be raised and supported medically; nobody adds it to your claim for you.
4. Returning to work and assuming that ends it
A schedule loss of use award is not wage replacement. It is payable whether or not you went back to work and whether or not you lost any wages at all.
Workers who return to the job, manage, and stop thinking about the claim close their own cases without ever reaching the award that compensates the permanent loss.
Common knee injuries in New York workers’ compensation claims
- Meniscus tears, medial and lateral
- ACL, PCL, MCL and LCL tears
- Patellar injuries, including fractures and dislocations
- Chondromalacia and cartilage damage
- Tibial plateau fractures
- Post-traumatic arthritis leading to replacement
Knees take the damage in falls from height and from ladders, in twisting injuries on uneven ground, in repetitive kneeling trades, and in the constant walking and lifting of warehouse, delivery and healthcare work.
Frequently asked questions
Is a knee injury a schedule loss of use in New York?
Yes. The knee is evaluated as loss of use of the leg, which carries 288 weeks at total loss. Your award is a percentage of that figure based on measured range of motion at maximum medical improvement.
What is a knee replacement worth in a New York comp claim?
Under the 2018 Guidelines a total knee replacement with a good outcome starts at 35 percent loss of use of the leg, with additional deficits added on top. A replacement with a poorer result carries a higher figure.
Does a meniscus surgery have a set value?
Not since 2018. The special considerations for meniscal tears were removed from the Guidelines, so the award follows your measured flexion and extension rather than the fact of the tear or the arthroscopy.
I hurt my good knee favoring the injured one. Does that count?
It may. An injury that develops as a consequence of the original work injury can be added to the claim, and the other leg is a separate scheduled member. It needs to be raised and supported by medical evidence.
Can I receive an award if I am back at work?
Yes. The award compensates permanent loss of use of the leg. It does not depend on lost wages and returning to work does not forfeit it.
I was out for months after knee surgery. Does that reduce my award?
Payments already made are credited against a schedule award, but New York’s protracted healing period provision sets a normal healing period of 40 weeks for the leg, and weeks of temporary total disability beyond that are added to the award period. Long knee recoveries reach that threshold fairly often.
When is my knee measured for the award?
After you reach maximum medical improvement, when your doctor files a C-4.3 to that effect. Measuring too early, while the knee is still stiff from surgery or still improving, risks fixing a figure that does not represent where you finish up.
Talk to a New York workers’ compensation attorney
If you have a knee injury from work, and either nobody has explained what your award should be or the carrier’s examiner has returned a percentage that does not match how your knee actually moves, have the file reviewed before anything is finalized.
The Law Offices of Frank J. Dito, Jr. represents injured workers throughout Staten Island, Brooklyn and New York. Call 718.701.2776 (toll-free: 800.310.5520) or contact us for a free consultation. Consultations are free. If we don’t recover money for you, we don’t get paid.
Related: shoulder injuries and schedule loss of use, and how schedule loss of use awards are calculated.
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