Understanding the Permanent Disability Rating System
Your permanent disability rating will determine how much you get in permanent disability.
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Permanent disability ratings are used to assess the degree of damage that resulted from your work-related injury or occupational disease. A permanent disability rating, sometimes known as a permanent impairment rating, is an assessment of the severity of your permanent impairment. A permanent disability rating is important in calculating the amount of monetary compensation you are owed to compensate you for the permanent impairment related to your workplace injury or illness.
If an injury permanently impairs your physical condition and/or mental health condition in any way, no matter how minimal, then you have permanent impairment. That does not mean you will necessarily receive a permanent impairment award. In some states, low levels of permanent impairment do not result in a monetary award.
When Is Permanent Disability Determined?
Once your medical condition has reached a stationary level, at which there is no further treatment available that will improve your condition, your doctor may assess whether you have any permanent disability. This stage is commonly referred to in many states as “maximum medical improvement.” This does not mean the point at which your condition will never improve; it simply means the point at which your condition is stationary and will not improve other than with the passage of time.
How Is a Permanent Disability Rating Determined?
Your doctor, or a doctor who handles workers' compensation cases, will assess your condition through a physical examination to determine the severity of your permanent impairment. While the physician who has been treating you for your workers’ compensation claim may evaluate your permanent disability, some treating physicians refuse to evaluate permanent disability, and instead ask that an independent medical examiner experienced in permanent disability ratings rate your permanent impairment.
In addition, in many states, your employer (or its insurance company) is allowed to request an independent medical examination for the purposes of assessing permanent disability.
Regardless of the which doctor assesses your permanent disability, the doctor will perform certain tests to determine the level of your impairment. For example, if you have a permanent problem with your shoulder, your doctor will likely perform tests to determine your reduction in range of motion. The tests are non-invasive.
Based upon the results of the tests and the overall physical and/or mental examination, the doctor will use the state-required guidelines to determine the degree of your permanent disability. These can be referred to in percentages, such as 5% permanent disability of the right shoulder, or degrees or categories, depending on the terminology used in your state.
Each injured body part is given a separate disability rating based on the severity of the injury. Some states combine the impairment ratings to determine an overall level of bodily impairment, known as a whole person impairment rating. The whole person impairment rating is a percentage rating of your disability, and can vary from 0% to 100% depending on the level of permanent disability and the reduction on future income earning capabilities.
Most states use the American Medical Association’s (AMA's) book Guides to the Evaluation of Permanent Impairment to assess disability. Which edition of this book your state uses (the 3rd, 4th, or 5th) is an important consideration, as the criteria for each level of permanent impairment has been modified slightly in each edition.
Other states have created statutory framework similar to the AMA Guides to the Evaluation of Permanent Impairment. This includes Florida, Minnesota, New York, North Carolina, Oregon, Utah, and Wisconsin. Still other states (Michigan, Missouri, Nebraska, New Jersey, South Carolina, and Virginia) do not specify a state guideline to use in evaluating permanent disability.
Some of the largest states use a hybrid system to rate permanent disability. For instance, California uses their own "Permanent Disability Rating Schedule," an impairment rating system derived from the 5th edition of the AMA Guides. However, the schedule adjusts the ratings from the AMA guide to account for future earning capacity, occupational requirements, and the worker’s age.
Florida and New York use their own guides, which are not based on the AMA Guides. Florida uses the Florida Uniform Permanent Impairment Rating Schedule. New York’s guide is called “Medical Guidelines,” which is a disability guideline reference doctors in the state must use to determine an injured worker’s level of permanent disability.
Some states use the AMA Guides for evaluation of certain disabilities, and their own statutory framework for evaluation of other disabilities. Your doctor, or the doctor who rates your disability, can discuss your permanent disability rating with you and the methodology used in calculating that disability.
Importance of the Permanent Disability Rating
States use your permanent disability rating to determine the amount of monetary compensation you will receive to compensate you for your permanent impairment due to your industrial injury or occupational disease.
In some states, the permanent disability rating corresponds to a certain number of weeks of wages worth of income you will be paid. For example, in California, a 10% permanent disability amounts to 30 weeks worth of wages.
In other states, your permanent disability rating corresponds to an exact dollar figure. For instance, a 8% left knee impairment may equal $4,572. You would receive $4,572, either in installment payments or in a lump sum.
It is important to remember that permanent disability awards are made near the end of your workers’ compensation claim, after you have reached maximum medical improvement and your permanent disability has been evaluated.
Get Legal Advice
If you have questions regarding the rating given to you, or if you need help for your workers’ compensation claim, consult a workers' comp attorney in your area. If your injuries are severe, you likely have a substantial amount of permanent disability, and you want to ensure that you receive compensation to the greatest extent possible.