When dealing with a workers' compensation claim, understanding impairment rating assessments is essential to determine the extent of an injury and how it affects a worker's ability to earn a living. Impairment ratings play a significant role in calculating benefits and ensuring that injured workers receive appropriate compensation for their disabilities. This article explores how impairment ratings work, their importance in workers' compensation claims, and what injured employees should know when navigating this complex process.

What Is an Impairment Rating?

An impairment rating is a medical evaluation that quantifies the degree of permanent impairment a worker has suffered due to a workplace injury. It is expressed as a percentage, which represents the extent of the physical or functional loss. This percentage helps determine the level of benefits an injured worker is entitled to receive.

Impairment ratings are typically conducted once an individual reaches Maximum Medical Improvement (MMI)—the point at which their condition has stabilized and is unlikely to improve with further treatment. These assessments are conducted by qualified physicians who follow specific guidelines to ensure consistency and fairness. Many states use the American Medical Association's (AMA) Guides to the Evaluation of Permanent Impairment as a standard reference for determining impairment.

Temporary vs. Permanent Impairment

It's important to distinguish between temporary and permanent impairments, as this distinction affects the benefits a worker can receive:

• Temporary Impairment: This occurs when the injury temporarily affects a worker's ability to perform their job. Benefits are provided during the recovery period until the worker can return to work or reaches MMI.
• Permanent Impairment: If the injury results in lasting physical or functional limitations, it is considered permanent. A physician will assess the impairment and assign a rating to indicate its severity.

Permanent impairments are further classified into partial or total disability. For example:

• Permanent Partial Disability (PPD): The worker has a lasting impairment but can still perform some type of work.
• Permanent Total Disability (PTD): The worker cannot perform any substantial gainful activity due to their injury.

How Impairment Ratings Affect Workers' Compensation Benefits

Impairment ratings directly influence the compensation an injured worker can receive. In many states, the percentage of impairment is used to calculate the duration and amount of benefits available under permanent partial disability (PPD) or permanent total disability (PTD) categories.

For instance, a worker with a 10% impairment rating might be entitled to a specific number of weeks of compensation, whereas someone with a 50% impairment rating would likely qualify for a longer duration of benefits. The specific formulas and methods for calculating these benefits vary by state, but they are generally based on:

• The worker's average weekly wage
• The severity of the impairment
• Applicable state workers' compensation laws

Some states have schedules of benefits that specify compensation amounts for different body parts (e.g., arm, leg, hand), while others use a more general approach.

The Impairment Rating Assessment Process

The impairment rating process can be complex, and it's important for injured workers to understand how it works:

Selection of Physician

Workers may be evaluated by an independent medical examiner or their treating physician, depending on the state's workers' comp regulations. Some states allow workers to choose their own doctor for the assessment, while others require evaluation by a designated medical professional.

Medical Examination

During the evaluation, the physician reviews medical records, conducts a physical examination, and may request additional diagnostic tests. They will assess the extent of the injury and determine whether the worker has reached MMI.

Assignment of an Impairment Rating

Using standardized guidelines, the physician assigns an impairment rating as a percentage. This rating is then used by the workers' compensation insurer or board to calculate benefits.

Disputes and Second Opinions

It's not uncommon for workers to disagree with the impairment rating assigned by the physician. In these cases, they have the right to seek a second opinion or request an independent medical examination (IME). Disputes over impairment ratings can significantly impact the benefits a worker receives, so it's essential to seek legal advice if there are concerns about the accuracy of the rating.

Common Mistakes to Avoid During an Impairment Rating Assessment

Injured workers must approach the impairment rating process carefully to ensure they receive fair compensation. Common mistakes to avoid include:

• Skipping Follow-Up Appointments: Not attending scheduled medical appointments may result in an inaccurate assessment of your condition.
• Failing to Provide Complete Medical History: Ensure the physician has all relevant medical records, including diagnostic tests and treatment notes.
• Accepting a Low Rating Without Question: If the impairment rating seems inconsistent with your condition, seek a second opinion.

Why Legal Representation Matters

Navigating the workers' compensation system can be overwhelming, especially when permanent disability and impairment ratings are involved. An experienced workers' compensation attorney will help injured workers:

• Understand the impairment rating process
• Ensure medical evaluations are conducted fairly
• Dispute inaccurate ratings or benefit calculations
• Maximize their compensation

According to the National Safety Council (NSC), workplace injuries cost U.S. employers over $163.9 billion annually, with an average cost of $1,100 per worker. Given these high stakes, having knowledgeable legal support is crucial to securing the benefits you deserve.

Conclusion

Impairment rating assessments are a vital part of the workers' compensation process, determining the benefits an injured worker will receive for a permanent disability. By understanding how impairment ratings are assigned and their impact on compensation, workers can better navigate the system and protect their rights. If you are facing an impairment rating assessment, consult with a qualified attorney to ensure that your evaluation is fair and that you receive the compensation you deserve.

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Navigating Workers' Compensation Claims can be challenging. Fortunately, you don't need to do it alone. The experienced lawyers at Brandon J. Broderick, Attorney at Law, are available 24/7 to help you understand your legal options, gather necessary evidence, and build a strong case to secure the settlement you deserve.

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