What is an Impairment Rating in Workers’ Compensation?

One significant aspect of workers’ compensation claims is impairment ratings. Whether dealing with permanent impairment, partial disability, or temporary income benefits, an impairment rating in workers’ compensation is a standardized measure to assess the impact of the injury on the worker’s ability to perform daily activities and job functions.

The impairment rating is not just a number; it influences the duration and amount of compensation benefits. It also reflects the extent of permanent damage resulting from a workplace injury. When a worker suffers a job-related injury, an Atlanta work injury lawyer can help them understand the path to recovery and compensation.

Impairment Ratings Explained by a Lawyer

An impairment rating is a medical number that helps show the level of permanent damage a person has after they finish medical treatment. The rating is given as a percentage. For example, someone might be given a 5% or a 25% impairment rating, depending on how the injury affects their ability to function.

Who defines the impairment rating?

A designated doctor or other approved medical provider usually gives the impairment rating after the injured person reaches maximum medical improvement (MMI). You may need to consult an Atlanta workers’ compensation lawyer to find answers for your specific case.

Common Types of Impairment Ratings

Doctors may assess the following kinds of impairments depending on the injury and medical condition:

• Whole-person impairment: A rating that reflects the total impact on the worker’s body.
• Extremity impairment: A rating for a specific body part, like an arm or leg.
• Mental impairment: This is for cases where the injury affects the worker’s mental or emotional health.
• Functional impairment: This refers to how the injury affects the person’s ability to perform basic work activities or other tasks.

These ratings are based on objective evidence, physical exams, and the patient’s description of symptoms, pain, and limitations. In some cases, Functional Capacity Evaluations (FCEs) or other special exams are used to measure how much work the person can still do.

Those aspects are important since they can affect the amount of your workers’ compensation settlement. Understanding what an impairment rating in workers’ compensation does can help injured workers prepare for the next step in their comp claim and avoid mistakes that could affect their benefits. Talking with a compensation lawyer can be helpful.

Impairment Ratings Evaluation Process

A Designated Doctor, treating physician, or another approved health care provider will do the evaluation. This often includes a full review of the worker’s medical records, treatment history, and current physical limitations.

Maximum Medical Improvement (MMI)

Before an impairment rating is assigned, the injured worker must reach MMI. MMI signifies that the worker’s condition has stabilized and is unlikely to improve further with medical treatment.

Medical Evaluation

This evaluation may include reviewing medical records, conducting physical examinations, and utilizing diagnostic tools like nerve conduction velocity tests. The doctor then assigns an impairment rating based on established guidelines, such as the American Medical Association’s Guides to the Evaluation of Permanent Impairment.

Functional Capacity Evaluations (FCE)

In some cases, a Functional Capacity Evaluation (FCE) may be performed to determine the worker’s physical capabilities and limitations. This assessment helps in understanding how the injury affects the worker’s ability to perform job-related tasks and daily activities. The results of the FCE can influence the final impairment rating and subsequent compensation benefits.

The doctor will use set impairment rating criteria, which may include the 5th Edition, 6th Edition, or another version of the AMA Guides to the Evaluation of Permanent Impairment.

What Affects the Evaluation Process?

Several factors may play a role in how the impairment is evaluated:

• Injury in question and any pre-existing conditions
• Consistency of symptoms and history of treatments
• The patient’s pain threshold, functional effects, and overall physical condition
• Accuracy of medical reports, medical expenses, and details from the comp claim

If the insurance carrier or the injured worker disagrees with the result, a second opinion or an independent medical evaluation may be requested. Having a clear record of the worker’s medical care, activity limitations, and treatment recommendations can help make the process more fair.

Common Disputes Over Impairment Ratings

Impairment ratings can lead to disputes between injured workers and the insurance company when there is disagreement about the percentage of impairment or how it was calculated. In many cases, the worker may feel the impairment rating does not reflect their actual pain levels, functional limitations, or the effects of their work-related injury on their daily life.

Common reasons for disputes include:

• Use of a different edition of the AMA Guides (e.g., 5th Edition vs. 6th Edition)
• Disagreement over whether the worker has reached maximum medical improvement
• Belief that the designated doctor or evaluator did not consider all medical records or overlooked medical evidence
• Differences in how bodily function or loss of function is measured
• Arguments about whether pre-existing conditions, mental impairment, or nonphysiological pain were factored in fairly

These disagreements may affect how long a person receives impairment income benefits, whether the person qualifies for permanent disability payments, or how much compensation benefits they are owed. 

Consult a Workers’ Compensation Lawyer at No Cost

Getting through the workers’ compensation process, especially when dealing with impairment ratings, can be challenging. Engaging a compensation lawyer can provide much-needed clarity and support. Lawyers at John Foy & Associates offer free consultations, allowing injured workers to understand their rights and options without financial commitment.

A compensation attorney can assist in reviewing medical evaluations, gathering supporting evidence, and advocating on behalf of the injured worker in case of disagreements or appeals. Getting help from The Strong Arm™ of John Foy can be a valuable step in securing the benefits and support you need during recovery.