How is a Permanent Disability Rating Decided?

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How is a Permanent Disability Rating Decided?

For injured workers who were seriously injured in an on-the-job accident, the permanent disability rating system may seem like a mystery.  Your assigned rating can seem arbitrary, not at all reflective of the injuries sustained, and could even be insulting.  Though all qualified medical examiners (QMEs) use the same permanent disability guidelines, different QMEs can arrive at wildly different ratings.  And it’s likely not a coincidence that the medical examiners preferred by the insurance companies tend to issue lower permanent disability ratings.

Permanent disability ratings are issued based on guidelines from the American Medical Association (AMA).  After it’s determined that additional treatment will not be beneficial, the injured worker is declared to be permanent and stationary (P&S).  A QME will then perform a series of tests to determine your degree of disability.  Each body part is assigned a separate rating, so if your work injury resulted in an arm injury and a leg injury, both body parts would be evaluated separately, with each assigned a disability rating.  Disability ratings can be anywhere from 0 percent to 100 percent.  When the disability rating of each injured body part is determined, a complicated mathematical formula then takes over.

First, the assigned disability ratings are converted into a combined rating, called the ‘whole person impairment rating’.  The whole person impairment rating is then adjusted on a variety of factors.  First, the rating is adjusted by future earning capacity.  The more likely your injury is determined to reduce your ability to earn money, the higher your rating is adjusted.  Hand and vision injuries are at the low end, while hearing and psychiatric injuries are at the high end.  The adjustment factor is between 1.1 and 1.4.  Next is a rating adjustment for the type of occupation and specific occupation.  Generally, the more labor intensive your occupation, the larger the adjustment factor.  Less intensive jobs, such as office work, may be adjusted lower.  Finally comes the age adjustment.  Injured workers between the ages of 37 and 41 see no adjustment.  Older workers will be adjusted higher while younger workers will be adjusted lower.  The older or younger you are from 37-41, the higher or lower the adjustment.  After all of the adjustments are calculated, workers are assigned their permanent disability rating.

For a full look at the calculation of a permanent disability rating, click here.

The permanent disability rating is extremely important, as it determines the level of workers’ compensation benefits an injured worker will receive.  While many of the factors that go into the determination of a permanent disability rating are set in stone by law, the examination of injured body parts by a QME is subjective.  That’s why working with a workers’ compensation attorney is incredibly important.  Attorneys can identify when a permanent disability rating is low and help their clients seek second opinions.

The Law Offices of Scott Warmuth helps injured workers through the complicated workers’ compensation claims process.  For a free work injury consultation, call 888-517-9888 today!

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