Permanent total disability is one of the only ways to qualify for benefits for life. If you don’t understand how it’s evaluated, it’s easy to lose benefits without realizing it. Let’s break down how PTD really works in New York, what insurers look for, and what can help—or hurt—your case.
Under New York law, PTD means you’re unable to perform any gainful employment at all—not just your old job, and not just physical work. The real question is whether you can realistically do any job in the New York labor market on a consistent basis.
This is where cases fall apart. A doctor might say you’re totally disabled from construction or warehouse work, and that may be true. But if the carrier can argue you could still do sedentary or light-duty work, they’ll claim you’re not permanently totally disabled.
PTD applies only when your injury, combined with your real-world limitations, leaves you with no realistic way to earn wages.
The Timeline: Temporary Disability vs. Permanent Disability
Disability status isn’t locked in from day one.
Early in a case, most disability is considered temporary. Right after an accident, workers are often temporarily totally disabled. As treatment continues, that status can change depending on medical opinions, surgeries, IMEs, and court decisions.
The turning point is Maximum Medical Improvement (MMI). That’s when doctors agree you’ve plateaued and aren’t expected to significantly improve. Once you hit MMI, the case shifts.
Before MMI, the focus is how bad the injury is right now. After MMI, the focus becomes what this injury means for the rest of your working life. That’s when the Board decides whether your disability is permanent—and whether it’s partial or total.
Why Two People With the Same Injury Can Get Very Different Outcomes
Two workers can have the same injury and the same surgery, but very different backgrounds. A younger worker with education, strong English skills, and non-physical work experience may be seen as able to transition into another job. An older worker with limited education, limited English, and a lifetime of heavy labor may realistically have nowhere to go.
Same injury. Different realities. That’s why PTD is really about employability—not just medical severity.
How Insurance Companies Try to Defeat a PTD Finding
Insurance companies fight PTD cases hard because lifetime benefits cost them a lot of money. One common move is narrowing the definition of “total disability.” They’ll ask whether you’re disabled from your old job—or from all jobs. That distinction matters.
They’ll also push the idea of sedentary or light-duty work, asking about sitting, standing, lifting limits, and position changes. The goal isn’t to prove you’re healthy—it’s to prove you can do something.
IME doctors are often used to suggest even minimal work capacity. That small opening is usually enough for the carrier to argue against PTD.
Why Permanent Total Disability Matters So Much
PTD is the only classification in New York workers’ comp that allows for lifetime wage benefits. If you’re found permanently totally disabled, you receive two-thirds of your average weekly wage, paid weekly for life, subject to the maximum rate.
Permanent partial disability works very differently. Partial benefits are capped and time-limited, even for serious injuries. Once the weeks run out, the checks stop.
Weekly Caps—and Why Your Average Weekly Wage Still Matters
PTD benefits are capped at a maximum weekly rate, no matter how much you earned before your injury.
That doesn’t mean your average weekly wage (AWW) doesn’t matter. It’s still the foundation for how benefits are calculated—especially in permanent partial cases where benefits are paid as a percentage.
If your wage is understated, every benefit calculation is lower. Overtime, bonuses, and multiple jobs all matter. Getting AWW right early can make a big difference over time.
The Hidden Downside of Permanent Total Disability
PTD benefits do not increase with inflation. There are no cost-of-living adjustments. Whatever weekly amount you’re awarded is what you’ll receive for life, even as expenses rise. PTD provides stability, but it’s not immune to the long-term cost of living.
The Biggest Risk to PTD: Working, Volunteering, and “Side Hustles”
PTD is based on the idea that you cannot work at all. Any paid activity—no matter how small—can be used to argue you’re not totally disabled. Side gigs, online sales, helping someone’s business, or monetizable social media can all be framed as work. Volunteering can be risky too. If you can regularly perform tasks, insurers may argue you can do similar work for pay.
Settling a Permanent Total Disability Case
PTD cases can sometimes be settled for a lump sum. For insurance companies, settlement limits long-term risk. For injured workers, it offers certainty and freedom from ongoing monitoring. But settling also means giving up guaranteed weekly checks. It’s a serious decision that depends on your age, health, finances, and long-term goals.
There are two main ways to qualify.
The first is total industrial disability, where you’re not medically 100% incapacitated but are effectively unemployable. The Board looks at age, education, language ability, and work history together to decide whether your employability is realistically zero.
The second involves catastrophic or extremely severe injuries—such as loss of both arms, both legs, both hands, both feet, or vision in both eyes. Loss of two major body parts also qualifies. Severe spine injuries, brain injuries, paralysis, and organ damage may qualify depending on the facts.
In every case, the focus is employability—not just how bad the injury sounds.
If you’ve been seriously injured at work and you’re not sure where your case is heading, it can help to talk things through with someone who handles New York workers’ comp every day. Give me, Rex Zachofsky, a call anytime.
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