Knee injuries are among the most common and most valuable workers' compensation claims involving a scheduled body part in New York. Unlike back injuries — which follow a non-schedule permanency process — knee injuries fall under the Schedule Loss of Use framework because the knee is part of the "leg," which is a scheduled body part. This distinction has enormous financial implications and shapes how the entire case is evaluated.
How the Knee Fits Into the Schedule
Under New York Workers' Compensation Law §15(3), the leg is scheduled at 288 weeks. The knee is evaluated as part of the leg. When you sustain a permanent partial impairment of the knee, you receive a Schedule Loss of Use award equal to the SLU percentage multiplied by 288 weeks multiplied by your compensation rate.
For example: a 35% SLU of the leg with a comp rate of $900/week = 35% × 288 × $900 = $90,720.
This is why the SLU percentage is the most contested number in a knee injury case. A difference of 10 percentage points can mean $25,000 or more in your pocket.
Common Work-Related Knee Injuries
Torn meniscus
The meniscus is the cartilage cushion inside the knee. Meniscus tears are common in workers who kneel, squat, lift, or pivot on their knees — construction workers, plumbers, floor installers, nurses. A torn meniscus is diagnosed by MRI. Treatment may be conservative (physical therapy, injections) or surgical (arthroscopic meniscectomy or repair).
ACL and ligament tears
Anterior cruciate ligament (ACL) tears typically result from a sudden twisting force or direct blow to the knee. They are common in falls, slips, and accidents requiring sudden directional change. ACL reconstruction surgery has a significant recovery period and typically results in a meaningful SLU rating.
Patella injuries
A fractured or dislocated patella (kneecap) is most common in direct-impact accidents. Post-surgical changes and residual limitations affect the SLU percentage.
Total knee replacement (TKR)
For workers with severe joint degeneration caused or accelerated by workplace injury, total knee replacement may ultimately be required. TKR typically results in a high SLU percentage — often 50% or more of the leg — because of the permanent functional limitations associated with a prosthetic joint.
Cumulative/degenerative knee injuries
Repeated kneeling, squatting, and loading over years of work can accelerate degeneration of the knee joint. These cumulative injuries may qualify as occupational disease claims even without a single traumatic accident. The "date of accident" for these claims is typically the date of disability or last injurious exposure.
The Permanency Process for Knee Injuries
Once your treating doctor determines you have reached Maximum Medical Improvement (MMI), both your treating physician and the carrier's IME doctor will evaluate your knee and assign an SLU percentage. The WCB Medical Treatment Guidelines provide specific criteria for rating common knee conditions.
What drives the SLU percentage?
- Range of motion deficits — reduced flexion or extension in the knee directly translates to a higher SLU percentage under the Guidelines
- Type of surgery — procedures like meniscectomy, ACL reconstruction, and total knee replacement each carry specific minimum ratings
- Retained hardware — in some cases, retained surgical hardware is a factor
- Instability and weakness — residual instability, quadriceps weakness, and giving-way episodes support a higher rating
- Pain and functional limitations — documented limitations in activities of daily living and work capacity
When the IME and Treating Doctor Disagree
In knee cases, it is extremely common for the carrier's IME doctor to assign a lower SLU percentage than your treating physician. When there is a dispute, the Workers' Compensation Law Judge weighs the competing medical evidence. The judge considers the quality of the examination, consistency with the WCB Guidelines, and the overall persuasiveness of each report.
This is where representation by an attorney experienced in permanency cases makes a significant difference. An attorney can ensure your treating doctor submits a thorough, well-documented report that addresses the Guidelines criteria explicitly — and can challenge an IME report that fails to do so. Learn more about what happens when conflicting medical opinions go before a Judge in our guide to workers' comp hearings.
Temporary Disability While the Knee Heals
While you are recovering from your knee injury — whether conservatively or post-surgery — you are entitled to Temporary Total or Temporary Partial Disability benefits based on your Average Weekly Wage. Temporary disability continues until you return to your regular work or reach MMI, at which point the SLU evaluation begins.
Post-surgical recovery from ACL reconstruction typically involves 6–12 months of rehabilitation. Total knee replacement recovery can take 12 months or more before MMI is reached. During this entire period, temporary disability benefits should be paid continuously at the appropriate rate.
Prior Knee Awards and Deductions
If you had a prior workers' comp case involving the same knee, any prior SLU award will be deducted from your current award. This prevents double recovery for the same impairment. However, if the current injury resulted in additional impairment beyond what was previously compensated, you are entitled to an award for the increment.
Settling a Knee Case
Many knee injury cases settle through a Section 32 Waiver Agreement. The settlement value for a knee case is primarily driven by the expected SLU percentage — which is why it is important to wait until MMI is reached and permanency is established before seriously evaluating any settlement offer. Settling before full permanency is known almost always means undervaluing the case.
Estimate your SLU award
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Open SLU Calculator →Key Takeaways
- The knee is evaluated as part of the "leg" — scheduled at 288 weeks under WCL §15(3)
- Knee injuries result in SLU awards, not LWEC classification (unlike back injuries)
- The SLU percentage is driven by range of motion, surgery type, instability, and residual symptoms
- Total knee replacement typically results in a high SLU percentage (often 50%+)
- Do not accept a settlement before MMI is reached — the full permanency picture is not yet known
- When the IME doctor assigns a lower percentage than your treating doctor, a hearing resolves the dispute