Impairment Ratings: What You Should Know

When a workplace injury occurs, the workers’ compensation process can be overwhelming. One important component is understanding impairment ratings, which can be crucial in determining the benefits you receive. Whether you’ve just been injured or are in the process of a workers’ compensation claim, understanding impairment ratings can help you make informed decisions and ensure you receive the compensation you deserve. 

What Is an Impairment Rating?

An impairment rating is a medical evaluation used to determine the extent of permanent damage or loss of function caused by a workplace injury. This rating, expressed as a percentage, reflects how the injury affects a person’s ability to perform daily activities and work-related tasks. The higher the percentage, the greater the impairment and potential impact on the individual's life and earning capacity.

There are two main types of impairment ratings: whole-person impairment and body-part impairment. 

A whole-person impairment rating assesses the injury’s effect on the body as a whole. For instance, a 30% whole-person impairment rating means the individual has permanently lost 30% of their overall bodily function. This method is commonly used in states that follow the American Medical Association (AMA) guidelines.

A body-part impairment rating, on the other hand, evaluates the loss of function in a specific body part rather than the entire body. For example, a 5% impairment rating for a hand means there is a 5% permanent loss of function in that hand. Although this may seem minor, any loss of functioning can significantly affect a person's ability to work and perform daily activities.

The method used to determine impairment ratings varies by state, as different jurisdictions have specific guidelines for calculating compensation based on these ratings. Understanding how your state assesses impairment can help clarify your eligibility for benefits and legal options.

How Are Impairment Ratings Determined?

Impairment ratings are typically determined by a qualified medical professional, such as an occupational health physician. The evaluation, called an Impairment Rating Evaluation (IRE), follows specific guidelines that adhere to each state’s laws.

The physician will conduct a thorough examination, review your medical history, and assess how your injury affects your ability to perform daily activities. They may also consider diagnostic tests, imaging results, and functional capacity evaluations. Once the assessment is complete, the doctor assigns an impairment rating that reflects your permanent functional limitations, typically using a scale from 0 to 100.

This scale shows the percentage of impairment that the victim has suffered due to the workplace injury. 

Maximum Medical Improvement: The Role it Plays

Impairment ratings are primarily used to determine eligibility for long-term disability benefits and permanent injury compensation.

Before an impairment rating can be assigned, you must first reach Maximum Medical Improvement (MMI). MMI occurs when your condition has stabilized and is unlikely to improve significantly with further treatment. This does not mean you are fully healed, but rather that your recovery has plateaued, and any additional medical intervention will have limited impact.

Once you reach MMI, your physician will evaluate your condition to assess whether you have any permanent impairments. If so, they will assign an impairment rating based on their findings, which will play a crucial role in determining the benefits you may be entitled to receive. 

Why Impairment Ratings Matter

Impairment ratings are essential because they directly influence the benefits you may receive through workers' compensation. These ratings help determine the extent of your disability and the compensation to which you are entitled. 

For example, if you receive a 5% impairment rating, you may be eligible for a specific amount of compensation based on your state's workers' compensation laws. The calculation often involves multiplying your impairment percentage by a predetermined factor, such as your average weekly wage or a set number of benefit weeks.

In some cases, a low impairment rating might not reflect the true extent of your limitations, especially if the injury affects your ability to perform your job. If you believe your rating is inaccurate, you can seek a second opinion or request an independent medical examination.

Challenging an Impairment Rating

If you disagree with your impairment rating, you’re not alone. Many workers find that their initial rating doesn’t accurately reflect their condition. In such cases, you can challenge the rating and seek a fair assessment.

1. Request a Second Opinion

You can seek a second opinion from another qualified physician. This doctor may conduct their evaluation and provide a different impairment rating.

2. Independent Medical Examination (IME)

In some situations, it may be beneficial to obtain an IME conducted by a neutral third-party physician. This examination can provide an unbiased assessment of your impairment.

3. Legal Assistance

Consulting with a workers' compensation attorney can be beneficial if you face challenges with your impairment rating. An experienced workers’ compensation attorney can help you navigate the appeals process, gather necessary medical evidence, and advocate for your rights.

Understanding Impairment Ratings

Even a minor rating like 5% can influence your compensation, potentially qualifying you for a lump sum or periodic payments, depending on your state's laws. It’s important to note that the functional impact of an impairment can vary widely. For example, a 5% impairment to your dominant hand could significantly hinder your ability to perform job-related tasks compared to a 5% impairment in a less critical area.

In contrast, a 0% impairment rating indicates no lasting (or ratable) injury, meaning you are expected to resume your normal duties without restrictions. On the other end of the spectrum, a 50% impairment rating suggests significant limitations in performing daily tasks, often qualifying the individual for more substantial benefits. 

Protecting Your Rights

The workers’ compensation system can be complex, with different states having different laws. Navigating impairment ratings only adds to the complexity. To protect your rights and ensure you receive fair compensation, consider the following tips:

• Document everything: Keep detailed records of your medical treatments, doctor’s notes, and any correspondence related to your workers' compensation claim.
• Stay informed: Educate yourself about your state’s workers' compensation laws and how impairment ratings affect your benefits.
• Seek legal guidance: Don’t hesitate to consult with a workers' compensation attorney, especially if you believe your impairment rating is inaccurate or unfair.
• Follow medical advice: Attend all medical appointments, follow your doctor’s recommendations, and participate in required rehabilitation programs. 

Understanding impairment ratings is crucial for anyone navigating the workers' compensation system. These ratings play a significant role in determining the benefits you’re entitled to and can impact your financial well-being. By staying informed, documenting your case thoroughly, and seeking professional guidance when needed, you can ensure that you receive the fair compensation you deserve.