Today’s post comes from Kristina Thompson at the Jernigan Law Firm.
What does a disability rating mean for my workers’ compensation case?
Part 1: The Rating.
One important, and sometimes confusing, point in a workers’ compensation case occurs when an injured worker gets a disability “rating.” Today’s blog discusses what a rating is (and what it is not) for an accepted workers’ compensation claim.
Before we get any further though – let’s be clear – a rating is NOT a settlement. (More on this in Part II: What is the Value of a Rating and Should I Accept It?).
A disability rating is a medical-legal term that quantifies the degree of loss, in a percentage, an injured worker has suffered to a particular body part as a result of a workplace injury.
When is a rating assigned?
The rating is assigned when the injured worker’s treatment is stabilized. That does not mean the injured worker is back to their pre-injury medical status (although that would be ideal). It just means the injured worker is as good as they are going to get.
This is called “maximum medical improvement” or “MMI.” MMI varies from person to person.
If someone has surgery following an injury, it can take six months to a year. Sometimes longer. It all depends on how a person’s treatment progresses. Many factors come into play in reaching MMI – like how quickly the carrier authorizes treatment and how a person responds to conservative treatment.
How is the rating calculated?
Under the North Carolina Industrial Commission Ratings Guidelines, the doctor has discretion to assign whatever rating s/he feels is appropriate for the particular injury. “[T]he final rating of impairment should be entirely the examining doctor’s independent opinion based on his own knowledge, experience, and clinical examination.”
The doctor might consider various factors like: loss of range of motion, ongoing pain, and past / future surgery. The standard minimum rating for a person who undergoes knee, elbow, or shoulder surgery is 10%.
If the injured worker disagrees with the assigned rating, s/he has a right to get a second opinion on the rating. The injured worker is allowed to select this physician.
At an appointment for a rating, it is always important for the injured worker to fully describe any limitations s/he is experiencing as a result of the injury. Being a good historian is crucial throughout a workers’ compensation claim.