In California, workers who suffer a permanent disabling injury at work may qualify for workers’ compensation permanent disability benefits (full or partial). To obtain these benefits, workers must be evaluated and given a permanent disability rating based on the severity of their disability, with a 0% showing no reduction of earning capacity and 100% showing permanent total disability. The higher your rating, the more benefits you generally will be able to receive.
How is your permanent disability percentage calculated?
Proving that you have a permanent disability essentially requires establishing that your injury or illness will never improve. The doctor who is treating you or a qualified medical expert (QME) may prepare a permanent and stationary (P&S) report stating that you have a P&S condition and that you have reached “maximum medical improvement.” The report will describe the worker’s functional impairment and limitations and how the injury impacts their ability to engage in Activities of Daily Living (ADLs).
The P&S report will be sent to a workers’ comp claims administrator. If you disagree with information in the report, it is your job to send in your objections to the claims administrator within 30 days (or 20 days if you have an attorney).
Once the report has been received, you will receive a rating based on the P&S report and several other factors, including:
- Date of injury.
- Age when you were injured.
- Your occupation at the time of the injury.
- Apportionment (how much of your disability can be attributed to your job).
- Adjustment factor
What should I do if I disagree with my rating?
Your rating will determine your benefits, so if you disagree with your rating, it is important that you speak up. First, you can contact your claims administrator for a reconsideration of your rating. If that does not work, you may present your case to a workers’ compensation judge. You can also request a State Disability Rater to give you a rating, which you can use to support your case (if you saw a QME, a State Disability Rater automatically decided your rating).