What Benefits Are Paid for Permanent Disability?
If you are left with a permanent disability after your medical treatment has ended, you can continue receiving additional benefits for an extended period, or even the rest of your life.
Workers’ compensation covers medical bills and pays you two-thirds of your average weekly wage while you are out of work due to a temporary disability. If your treating physician finds that you are permanently disabled, you can receive additional payments as well, even if you are cleared to return to work.
How a permanent disability is determined
When you get treated for a work injury, you will continue to receive medical treatment until you have reached the point of “Maximum Medical Improvement” or been declared “Permanent and Stationary” by your doctor. What these terms mean is that you have improved as much as you are likely going to improve, regardless of whether you receive further medical care or not. You can continue to receive medical care over time, or your condition can fluctuate, and you can still be considered Permanent and Stationary (P&S).
At this point, you might be deemed fully cured or rehabilitated, or the doctor might decide you are permanently disabled. Your treating physician will prepare a P&S report that describes any permanent disability or disabilities, any continued need for treatment, and the functional limitations (work restrictions) each disability imposes on you. The P&S report also includes a whole person impairment (WPI) rating for each permanent disability, using standardized guidelines developed by the American Medical Association. The WPI rating is based on the impact that the disability has on your life and your ability to engage in daily living activities, including how much of the disability is due to the work injury versus any other factors outside the workplace.
The P&S report and the WPI rating are taken together with your age, occupation and type of disability to come up with a permanent disability rating, reflecting the extent that the disability impacts your earning capacity. A worker is considered permanently totally disabled with a rating of 100%. For any rating less than 100% but greater than zero, the worker will be considered permanently partially disabled.
Permanent partial disability
A permanent disability rating between 1 and 99% means you are partially disabled. This rating will determine how many weeks you can receive disability benefits. Permanent disability payments start when temporary disability benefits end or when you are declared Permanent and Stationary. They are paid every two weeks and last until your disability award is paid or your case gets settled.
Permanent total disability
It is possible but uncommon to receive a 100% permanent disability rating and be considered completely or totally disabled. Some conditions that would be considered a total disability include:
- Loss of sight in both eyes
- Complete paralysis
- Loss of the use of both hands
- A brain injury that is considered mentally incapacitating
Permanent total disability payments are paid for life at the temporary disability rate, adjusted annually as the state average weekly wage increases.
Disability rating disputes
If you disagree with your rating, you can request to have a QME evaluate you, request a disability rater to rate you, and negotiate with the claims administrator for a different rating. You can also ask for reconsideration of your rating at the Division of Workers’ Compensation (DWC) or take your case to a judge at the Workers’ Compensation Appeals Board (WCAB). For any of these steps, getting advice and representation from a qualified and experienced workers’ compensation attorney is recommended.
