Disability Ratings in California Workers’ Compensation
When a worker suffers an on-the-job injury that results in a lasting impairment, the California workers’ compensation system provides for permanent disability (PD) benefits. These benefits are based on a disability rating, which quantifies the severity and impact of a worker’s injury on their ability to earn a living. Understanding how disability ratings work is essential for injured workers seeking fair compensation. For help with a denied or delayed claim or other difficulty obtaining benefits in Orange County or the Inland Empire, contact Invictus Law, P.C., at our offices in Orange and Riverside to speak with a skilled and experienced Southern California workers’ compensation lawyer.
What Is a Disability Rating?
A disability rating is a percentage assigned to an injured worker’s permanent impairment after they reach maximum medical improvement (MMI). MMI means that the worker’s condition has stabilized and is unlikely to improve significantly with further treatment. The rating reflects how much the injury affects the worker’s ability to perform work-related tasks and earn income compared to before the injury.
Disability ratings can range from 0% to 100%. A 0% rating means there is no measurable permanent disability, while a 100% rating means the worker is permanently and totally disabled and unable to return to any kind of gainful employment.
How Are Disability Ratings Determined?
Once an injured worker reaches MMI, their treating physician or a qualified medical evaluator (QME) issues a medical report assessing the level of permanent impairment. This report follows the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, 5th Edition, as adopted by California law.
The report includes:
- A description of the injured body part(s) and the extent of impairment.
- A whole-person impairment (WPI) percentage.
- Apportionment of disability, if any part of the impairment was caused by a non-work-related condition.
The WPI is adjusted based on several factors, including the injured worker’s age and occupation. The adjusted rating is then converted into a permanent disability percentage using a formula established by the California Permanent Disability Rating Schedule (PDRS).
What Does the Rating Mean for Your Benefits?
Your disability rating directly affects the amount and duration of your permanent disability benefits. In general:
- Ratings under 100% qualify for partial permanent disability benefits. The benefits are paid out in weekly installments for a specific number of weeks based on the rating.
- A 100% rating qualifies the worker for total permanent disability benefits, which may be paid for life.
For example, a worker with a 15% disability rating may receive benefits for 60 weeks, while someone with a 50% rating may receive payments for several years. The weekly benefit amount is calculated based on the worker’s average weekly wage, subject to statutory minimums and maximums.
Disputing a Disability Rating
Disability ratings can be contested if either the injured worker or the employer disagrees with the medical evaluation. If the treating physician’s report is disputed, the parties may agree to use an Agreed Medical Evaluator (AME) or request a Qualified Medical Evaluator (QME) from a panel provided by the Division of Workers’ Compensation.
If a QME or AME issues a report with a different impairment rating, it may significantly impact the final benefits awarded. It’s important to have an experienced workers’ compensation attorney to review medical reports and advocate for a fair and accurate rating.
Supplemental Job Displacement Benefits (SJDB)
Injured workers with permanent partial disability ratings may also be eligible for Supplemental Job Displacement Benefits. This is a non-transferable voucher worth up to $6,000 that can be used for education-related retraining or skill enhancement if the employer does not offer suitable return-to-work options.
Eligibility for the SJDB voucher depends on several factors, including the worker’s permanent disability rating and the employer’s ability or willingness to accommodate work restrictions.
Why Legal Representation Matters
The disability rating process can be complex and highly technical. Errors in the rating or interpretation of medical reports can significantly reduce the amount of compensation an injured worker receives. An experienced workers’ compensation attorney can:
- Ensure medical reports are accurate and complete.
- Dispute incorrect ratings through the QME/AME process.
- Maximize the worker’s permanent disability benefits.
- Help secure additional benefits, such as SJDB vouchers or lifetime benefits for total disability.
Contact Invictus Law, P.C. for Help With Your Disability Rating in Orange County or the Inland Empire
At Invictus Law, P.C., we understand how critical your disability rating is to your financial recovery. If you’ve suffered a permanent injury on the job in Orange County or the Inland Empire, our experienced legal team is here to guide you through every step of the process. We’ll make sure your rating is fair, your rights are protected, and you get the benefits you deserve. Contact us today for a free consultation.
