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SeiferFlatow PLLC Blog

What is a disability rating?

Posted by Mathew Flatow on Jul 8, 2014 1:29:07 PM

You were injured at work. You went through all the medical treatments you need, but you will never fully recover. How will you be compensated for your permanent injuries? The answer depends on your disability rating, also called an "injury rating."

When do I get a disability rating?

Workers’ compensation laws ensure that you get the medical care you need, plus How much will I get. If you’re permanently disabled in some way, you’re also entitled to the future wages you’re losing as a result of the permanent damage. You may experience either Permanent Partial Disability (PPD), in which case you can work but your capacity is diminished, or Permanent Total Disability (PTD), in which case you cannot work at all. Any permanent disability merits a settlement from your employer as compensation for the permanent damage. Your disability rating determines the amount of that compensation.

Your doctor will give assign your injuries a disability rating once you’ve reached the point of Maximum Medical Improvement (MMI)

How do injury ratings affect my compensation?

A disability rating is a doctor’s judgment on the severity of your injury. Disability ratings are given as percentages. For example, a doctor may assign a 20% disability rating to your injured foot, meaning that you only have 80% functionality.

Your settlement for permanent disability is calculated based on your pay, the part of your body that is injured, and your disability rating.

Each part of your body is assigned a certain value. For example, your thumb is worth 75 weeks of pay. Your arm is worth 240 weeks. Your back is worth 300 weeks. In other words, if you lose your thumb, you are entitled to a full 75 weeks’ worth of pay. If you lose your arm, you’re entitled to 240 weeks’ worth of pay.

blog3The injury rating comes into play when you haven’t lost the body part or it isn’t totally disabled, but you still have permanent damage. That's a permanent partial disability, also called a permanent partial impairment. The North Carolina Industrial Commission publishes a comprehensive guide for doctors to determine the amount of disability you’ve suffered. For example, severe wrist damage is worth 50% of the value of your hand. If you suffered laceration of both tendons in a finger, it’s worth 90% of the value of the finger.

So, if part of your body suffers permanent partial disability, your doctor will determine the level of damage to that body part. That's your injury rating for that body part and will determine how much compensation you're entitled to from your employer.

Disability Rating Example

Let’s take a look at an example to illustrate how the disability rating system plays out.

Pete works for Construction, Inc., earning $800 weekly. He was involved in a demolition accident that resulted in the loss of hearing in one ear, serious nerve damage in one hand, and a broken foot. Upon completion of his medical treatments, Pete still can’t feel or move his hand and he still can’t hear out of one ear. His foot healed completely.

First, Construction, Inc. is responsible for the payment of all of Pete’s medical bills as he accrues them. Because his injuries prevent him from working, Pete is also entitled to compensation for the wages he would have earned had he not been injured. Now, we come to the issue of compensation for his permanent disabilities.

Under North Carolina standards, Pete is entitled to 90% of the value of his hand for complete sensory and motor damage to the nerves in that hand. A hand is valued at 200 week’s salary. In Pete’s case, that’s $160,000. So, he’s entitled to $144,000 for the permanent damage to his hand (90% of $160,000). He is also entitled to compensation for the loss of hearing. Total loss of hearing in one ear is valued at 70 weeks’ pay, which is $56,000 for Pete. In total, that’s a permanent disability settlement of $200,000.

Permanent Total Disability

Injury ratings only affect your compensation if your disability is partial. If your disability is total, meaning you can't work at all, you're entitled to compensation for it. In North Carolina, compensation for PTD is equal to 2/3 of your average weekly wages, but no less than $30. Your employer will have to continue to pay you that amount for 500 weeks. You may apply for extension of the 500-week term by showing that you have, in fact, no ability to earn a wage due to your injuries. After you reach retirement age, your employer may reduce payments by the amount of your Social Security benefits.

North Carolina law sets out specific qualifications for permanent disability. In order to qualify, you must have suffered the loss of both hands, arms, feet, legs, or eyes, or one each of any two of those. In other words, you qualify for permanent total disability if you lose both arms and you also qualify if you lose one arm and one eye. You qualify if you suffer a severe spinal injury that causes paralysis of your arms, legs, or torso. A brain injury that causes sensory, motor, communication, or cerebral function disturbances or neurological disorders qualifies for permanent total disability. Finally, you qualify if you have 2nd or 3rd degree burns over at least 1/3 of your body.

If your disability is total and permanent, you're entitled to medical care for that disability for the rest of your life.

Change in Condition

If you’ve received a settlement for permanent disability but your condition later worsens, you may be able to claim a larger settlement. You must file your claim within 2 years of accepting the original settlement or you will lose the right to make such a claim.

When should I accept a rating settlement?

Accepting a rating settlement will lead to the termination of any other disability benefits. If you’re still undergoing treatment, it’s too early to accept a settlement. It’s best to wait until you’ve recovered as much as possible and returned to work before accepting any kind of rating settlement. That way, you can make sure you’re still capable of working before you cut off your right to further disability payments. Reach out to an experienced attorney before accepting any settlement offer to ensure that you’re getting the compensation you deserve for your injury – you don’t want the insurance company to short-change you after you’ve suffered serious injury.

What should I do if I’ve suffered permanent disability?

If you were hurt at work, your first priority is to get all the medical care you need and carefully follow your treatment plan. When you reach the point of MMI, your doctor will assign a disability rating to your injuries. Your employer’s insurer will probably require a second opinion. If you disagree with the doctor’s evaluation of the severity of your permanent disability, you may also choose to seek a second opinion.

Even with second opinions to back up your claim, the insurer may choose to deny it. If that’s the case, it’s time to reach out to an an experienced attorney. Your attorney will help you file your workers’ compensation case and will negotiate on your behalf with the insurance company.

Topics: Settlement, Workers' Compensation, Insurance Companies, Blog, Compensation, North Carolina