What Does a 5 Impairment Rating Mean?
After suffering a work-related injury due to another party's negligence, one of the most important next steps is contacting a workers' compensation attorney. This attorney can help you get the right treatment for your injury and pursue the other party for compensation.
Getting the right treatment might be easy, but the same cannot be said about getting the compensation you deserve. This is because several factors come into play when calculating the type of compensation you deserve.
You need to remember that insurance companies won't part with their money that easily, even if they know their client is at fault for your injury. Instead, they'll want to review many things, among them the extent of damage, to justify the proposed compensation.
This is where a workers' compensation lawyer comes in to help you get the compensation you deserve, but the process isn't always as easy as it may seem on paper. It's not just a matter of walking into the insurance offices and presenting them with paperwork to sign. Without proof that you deserve the proposed compensation, there'll be no deal between the two parties.
What's an Impairment Rating?
In layman's language, an impairment rating is the percentage of damage to your body caused by a particular injury. This rating is usually provided at the end of your medical treatment.
In this context, the 'end of your medical treatment' is that particular point where doctors believe that your conduction won't improve with further treatment other than the passage of time.
Here's an example.
Suppose you get into a car accident, and you break your knee, requiring multiple surgeries. In that case, after the surgery, the doctors probably won't have anything else to do to improve your condition other than letting time do the rest of the healing.
The same applies if you suffered a brain injury and required surgery or any other medical treatment. After the treatment, you'll probably have to deal with memory loss, poor body balance, etc.
In such a case, doctors will describe your condition as “stable” and won't expect any more improvements within the next few months. In legal terms, when a patient is considered stable even though they can't resume some of their normal daily functions as described above, the patient is believed to have reached “maximum medical improvement.”
On the contrary, if you made a complete recovery and don't feel any pain or experience loss of function, the doctor will most likely record that you've made a 100% recovery. This means that you are back to normal, just like you were before the injury.
Now back to the permanent impairment rating.
This rating reflects the percentage of change from your normal pre-injury condition to the post-injury condition. The rating determines the amount of compensation you deserve based on the specific injury.
The permanent impairment rating system also varies from state to state. For example, an impairment rating of 5 percent will earn you at least 15 weeks of impairment income benefits in Texas.
How Is Permanent Impairment Rating Calculated?
This rating is usually calculated by a professional referred to as an Impairment Rating Evaluation (IRE). You can choose your preferred medical examiner if you disagree with the ratings provided by the initial examiner.
Some personal injury victims lie about their injury, hoping to be awarded more compensation than what the injury is worth. For this reason, employers appoint their own medical examiners to establish the most appropriate rating for a particular injury.
When calculating the rating, the independent professional uses a scale, usually between 0 and 100.
This scale shows the percentage of impairment the victim has suffered due to the injury. Therefore, a 5 impairment rating means the victim has suffered injuries affecting at least 5 percent of a particular body part.
An impairment rating can also be calculated based on the percentage of the entire body. This usually depends on the personal injury laws of that particular state. For example, a 30 percent bodily impairment rating means the victim has suffered impairment affecting at least 30 percent of their body.
The bodily impairment rating is also known as the whole person impairment rating in some states.
To further understand how the impairment rating system works, it's important to know the difference between disability and impairment in the legal system.
What's the Difference Between Disability and Impairment Rating?
Outside of the legal system, the terms disability and impairments are often used interchangeably, but things are slightly different when it comes to personal injury.
Personal injury laws define disability as the limits and restrictions on an individual's ability to complete their day-to-day activities. On the other hand, impairment is that specific issue affecting the physical condition or neurology of the person.
For example, if you slip and fall at a grocery store, hurting your back in the process, your back condition is considered an impairment. On the other hand, the inability to lift objects due to the back condition is considered a disability.
Did you know that you may be eligible for compensation if you suffer a grocery store injury? Click here for more details.
Impairment Rating Guide Explained
Most states have an impairment rating guide to ensure that insurers and personal injury victims follow the right legal channels. However, this guide varies from one state to another, and it's always advisable to refer to your state-specific guide for accurate information.
But, in general, here is the common procedure to obtain an impairment rating.
Receiving an Impairment Rating Evaluation Letter
Here, the injury victim receives a letter requesting them to attend an Impairment Rating Evaluation. This letter usually arrives only if the individual seeking compensation has received benefits for 104 weeks.
Scheduling and Attending an IRE Appointment
During the IRE appointment, the examiner will evaluate various factors, such as the extent of impairment, medical history, current medical tests results, etc.
Providing an Impairment Rating
After evaluating the factors mentioned above and more, the doctor will provide an impairment rating ranging between 0 and 100. For such a rating to be approved, the medical examiner must follow the latest version of the Guides to the Evaluation of Permanent Impairment, a book written by the American Medical Association, to determine the correct rating.
Creating an IRE Report
The medical examiner will then create a report based on the tests conducted on the victim of personal injury. They will then send this report to the insurance company and notify the victim of its impact on the expected benefits.
Appealing the IRE Report
Depending on the results of the report, the victim might find it necessary to file an appeal. This is totally acceptable as long as it's done within the specified period.
Why Is the Permanent Disability Rating So Important?
Having a permanent disability rating system comes with so many benefits. Firstly, for insurance companies, this system helps prevent insurance fraud.
Secondly, for victims of personal injury, it establishes a compensation structure that can't be simply dismissed by insurance companies that won't want to settle such claims. For example, suppose your permanent disability rating shows that you deserve $100,000 as compensation. In that case, insurance companies can't pay you less unless they come up with a legally-certified reason to prove otherwise.
In some states, this rating also corresponds to the number of weeks of wages worth of income you'll be eligible for after the injury. For instance, in California, a 10% disability rating equals 30 weeks' worth of wages.
Some states also have a fixed amount for various ratings. For instance, a 10 percent permanent disability rating could mean $5,000 worth of compensation.
Other states calculate impairment ratings based on the exact body part affected by the injury. In North Carolina, a 10 percent partial impairment rating to the leg is worth at least 20 weeks of benefits at your weekly compensation fee. Similarly, a 10 percent partial impairment rating to the arm is worth 24 weeks of benefits.
Partial Impairment Rating Explained
Partial impairment rating refers to any rating below 50 percent. When the personal injury victim has such a rating, he is believed to be able to return to work in some capacity.
For example, suppose you slip and fall while working at a grocery store as a security guard and then hurt your toe. In that case, you may be able to resume work after treatment but only for office-based tasks such as writing security reports.
What Does a 0 Impairment Rating Mean?
A worker with a 0 percent impairment rating is considered to have no impairment at all. Therefore, such a worker is expected to continue with their daily tasks as they would before the injury.
What Does a 50 Impairment Rating Mean?
An impairment rating of 50 (or above) means the personal injury victim has problems performing basic daily tasks and is totally impaired. Such an individual is usually eligible for higher benefits due to the injury.
What Does a 100 Impairment Rating Mean?
A 100 percent impairment rating describes a condition limiting an individual's ability to work and perform daily tasks. In such a case, the individual is eligible for total compensation.
For example, let's assume you've been seriously injured at work. If the medical examiner's report says you can no longer go to work and perform your daily tasks, your employer will have to pay you the total amount you make with them. So if you earn $4000 a month, you'll be eligible for $4000 monthly benefits for a specified period.
How Morgan & Morgan Can Help
When it comes to workers' compensation and personal injury in general, no other law firm in the United States fights for your rights better than Morgan & Morgan.
We understand how frustrating it can be to deal with insurance companies and medical examiners while at the same time struggling to recover from your injury. Remember, medical examiners who provide these ratings are usually hired by your employer and might want to protect their client's interests over what you deserve as compensation for the injury.
After receiving the impairment rating, you don't need to accept it if you believe you deserve more - you can request an independent medical examination with a physician of your choice at your employer's expense. And, if you disagree with their ratings, you can file an appeal, sending the claim to court for a hearing.
This is where Morgan & Morgan comes in to fight for your rights and ensure you receive the compensation you deserve. Our law firm comprises over 800 lawyers scattered all over the United States, guaranteeing you have someone to protect your rights regardless of your location.
Besides, workers' compensation laws are complex and vary from state to state. For this reason, it's never advisable to seek compensation without an experienced workers' compensation attorney from a reputable law firm like Morgan & Morgan - the best injury firm in the United States.
Need help with your workers' compensation claim? Send us a message online for a free, no-obligation quote evaluation, or call us at 877-602-8690 right away!