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How Permanent Disabilities are Evaluated

Woman feeling neck pain

Some workplace injuries are severe enough to cause long-lasting consequences and disabilities. When they are, a medical provider will need to evaluate the disability to understand just how much it will interfere with the claimant’s life and job. The end of this evaluation will include a “disability rating,” which will determine the extent of the benefits available to the claimant.

Comparing Stationary & Permanent Injuries

An employer-chosen physician will likely be the first person to see you after a workplace accident. They will diagnose your injuries and start the process of deciding your disability rating, assuming any such rating is even necessary.

Long-lasting injuries can be sorted into two categories by the treating physician:

  • Permanent: A permanent injury is one that is “unlikely to change” within the next year, regardless of the medical treatments provided to the patient.
  • Stationary: An injury can be called stationary if it has stabilized and is not expected to worsen or heal further unless drastic medical treatments are made.

However, an injury can also be categorized as stationary if it is causing a gradually worsening and terminal health condition. The idea is that a claimant who has a terminal injury that still allows them to work to some extent for the time being deserves similar or identical benefits as one who has a permanent injury that causes significant disabilities.

The treating physician needs to file a “permanent and stationary report” within 20 days of first evaluating you. In this report, they will describe the nature of your disability, such as permanent, stationary, or temporary, as well as whether they think your disability was suffered at work or not. The report will also outline workplace limitations you will more than likely experience because of your injuries. Lastly, and perhaps most importantly, this report will note how much future medical care you will need to continue healing or prevent a deteriorating condition.

Percentages of Disability

A percentage of disability – or whole person impairment (WPI) – will be assigned to your injuries. This percentage is meant to reflect how much your life and abilities are affected by the injury, with a higher percentage representing a worse disability. For example, someone who has a total permanent disability will likely be assigned a 100% disability rating. Someone who has lost some use in one hand, though, might only have a disability rating of 50% or lower.

Doctors in most states are instructed to use American Medical Association (AMA) guidelines to determine an injured worker’s disability rating. However, the guidelines can only be so useful in that every person is different and will respond to similar injuries differently.

Can You Disagree with the Doctor’s Evaluation?

There are plenty of times when an employee does not agree with the permanent and stationary report from the medical evaluator. For example, you might know you are still feeling the disabling effects of an injury, but the physician thinks you have reached your maximum medical improvement (MMI) without any signs of future complications. Even your employer might disagree with this report, but probably for a different reason like they think your injury was not caused because of a work-related duty.

To get a second opinion, employers and employees alike can request that another medical evaluation is conducted by a new medical professional or qualified medical evaluator (QME). It is important to remember that the QME might reach a conclusion that is less favorable to you than the first medical professional. For this reason, you should consult with an attorney before pressing for a secondary medical evaluation because your workers’ comp lawyer might be able to advise you on a better course of action based on their experiences.

Making Sense of California Workers’ Comp Rules

Are you trying to understand if you will get a fair disability rating after suffering a workplace injury in Southern California? Come to the Law Offices of Wax & Wax in Santa Clarita for compassionate and comprehensive legal guidance and services for everything workers’ comp related. We would be happy to discuss the key details of your case during a free consultation!