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Workers' compensation: understanding disability ratings

After suffering an illness, condition or injury at work in California and being approved for workers' compensation benefits, there might be a question as to whether the injured worker can receive permanent disability benefits. The key to this determination is the rating. The rating formulates a percentage of how much the disability affects the person's ability to work and how much work can still be performed. This rating is then used to decide the value of the permanent disability benefits.

There are several factors that are used to determine an injured worker's rating. These factors include the medical condition as it is described in the permanent and stationary (P&S) report, the date the injury occurred, the age of the person when he or she was injured, the occupation involved, how much of the disability was caused by the work in comparison to other factors - also referred to as "apportionment", and the multiplication by an adjustment factor.

With the multiplication by an adjustment factor, the number used depends on when the injury occurred. If it happened in 2013 or later, the adjustment factor will be 1.4. If it happened prior to 2013 and the 2005 rating schedule is used, the adjustment factor will stem from the reduced capacity to earn in the future. If the rating is 100 percent, the person will be deemed as having permanent total disability. This is considered a rare occurrence.

Those who receive a rating of 1 percent all the way up to 99 percent will get a rating of permanent partially disabled. Most injured workers will not have a permanent disability. If there is one, it is usually a rating of 5 percent to 30 percent if they were injured before 2005. With a workers' compensation claim, the claimant might disagree with the rating the claims administrator gives. It is possible to challenge the rating. A legal representative can have a negotiation with the claims administrator to see if a fairer resolution can be reached. If no agreement is made, a workers' compensation judge can be asked to decide on the rating.

An injured worker should be aware of the importance of disability ratings and rating schedules, as it can directly affect how much compensation he or she receives. After an injury at work, it can be difficult to keep track of the multitude of issues that will arise, including how the ratings are formulated and what to do if there is disagreement. Speaking to an attorney who is experienced in workers' compensation may therefore be of some assistance.

Source: dir.ca.gov, "Chapter 7. Permanent Disability Benefits, pages 32-33," accessed on Sept. 8, 2017

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