Call Us 919-240-4054If you’ve been injured on the job in North Carolina, you may be hearing terms like “impairment rating,” “maximum medical improvement,” or “permanent partial disability.” These concepts can significantly impact the benefits you receive through workers’ compensation, but injured workers often misunderstand them.
At Johnson & Groninger PLLC, we regularly see confusion about workers’ comp impairment ratings. Let’s break down what these ratings mean and how they affect your case.
What is a Workers’ Comp Impairment Rating?
A workers’ comp impairment rating is a percentage given to you by your doctor that measures the permanent damage to a specific body part after you’ve completed treatment. This rating represents how much function you’ve permanently lost compared to your pre-injury condition.
For example, if you injured your knee at work and underwent surgery, your doctor might determine that you have a 15% permanent impairment to your leg after you’ve healed as much as possible.
When is an Impairment Rating Assigned?
Your doctor will assign an impairment rating only after you’ve reached “maximum medical improvement” (MMI). This is the point where the doctor believes that your condition is stable, and that it is not likely to significantly improve, even with continued treatment.
Reaching MMI doesn’t mean you’re completely healed or pain-free. It simply means that your condition isn’t expected to improve substantially with additional treatment.
How Do Doctors Determine an Impairment Rating?
In North Carolina, doctors can use specific guidelines to determine impairment ratings. The North Carolina Industrial Commission provides a Rating Guide that helps doctors assign percentages based on the type of injury and the affected body part.
It is important to remember that the Ratings Guide is meant only as a reference for doctors. Doctors give ratings based on their own experience and medical knowledge. For example, the guide states that:
- A hand injury that damage a nerve so much that the thumb has little movement might be given a 35% rating to the hand
- An injured worker’s knee that can only bend up to to 90 degrees may result in a 15% impairment rating
- After surgery for a back injury to one disc level, the worker who continues to have pain might receive a 15% rating
These guidelines help ensure some consistency in ratings, but there’s still room for medical judgment. Two different doctors might assign very different ratings for the same injury.
Why Your Impairment Rating Matters
Your workers’ comp impairment rating directly affects the amount of permanent partial disability (PPD) benefits you may receive. In North Carolina, each body part is assigned a specific number of weeks of compensation under state law.
For example:
- Arm: 240 weeks
- Leg: 200 weeks
- Hand: 200 weeks
- Foot: 144 weeks
- Back: 300 weeks
To calculate your benefit, multiply:
- Your impairment rating percentage
- The number of weeks assigned to that body part
- Two-thirds of your average weekly wage before the injury
For example, if you have a 20% impairment rating to your leg, and you earned $900 per week before your injury, you would calculate:
- 20% × 200 weeks = 40 weeks
- 40 weeks × ($900 × 2/3) = 40 weeks × $600 = $24,000
This would be the PPD benefit amount for your permanent impairment.
Common Misunderstandings About Impairment Ratings
Misunderstanding #1: Rating vs. Settlement
One of the most common misunderstandings we see is confusion between receiving payment for an impairment rating and settling a workers’ compensation claim.
When you receive payment for your rating, your claim remains open. You still have the right to additional medical treatment for two years. This is very different from a settlement (sometimes called a “clincher”), which closes your claim completely.
Misunderstanding #2: Low Ratings for Significant Pain
Many injured workers are surprised and disappointed when they receive what seems like a low impairment rating despite significant ongoing pain. This happens because ratings primarily measure physical function rather than pain or discomfort.
The amount and frequency of pain you experience is important to your impairment rating, however. It is a part of your history that your doctor should take into consideration.
Misunderstanding #3: Ratings Are Final and Unchangeable
If you disagree with your doctor’s rating, you have the right to a second opinion. North Carolina law specifically provides that injured workers can obtain a second opinion on their rating at the employer’s expense.
Misunderstanding #4: Damage to Organs and Permanent Scarring Isn’t Considered
Permanent damage to important parts of your body means that the Industrial Commission will award compensation. The current maximum award is $20,000 per organ. There are also payments for scarring, depending on where the scarring is and how it affects you and your ability to work.
Getting a Second Opinion on Your Impairment Rating
If you believe your impairment rating doesn’t accurately reflect your condition, you can request a second opinion. Here’s how it works:
- You have the right to a second opinion evaluation with a doctor of your choice
- The employer/insurance carrier must pay for this evaluation
- You need to get approval from the Industrial Commission before proceeding
- The second doctor will perform an independent evaluation and assign their own rating
If there’s a significant difference between the two ratings, the North Carolina Industrial Commission may determine which rating, or an average of the two, applies to your case.
Rating Disputes: When Doctors Disagree
It’s not uncommon for different doctors to assign different impairment ratings for the same injury. When this happens, several factors may influence how the Industrial Commission calculates the rating:
- The qualifications and credentials of each doctor
- Whether the doctor regularly treats your type of injury
- How thoroughly each doctor examined you
- Whether the rating follows the Commission’s guidelines
- How well the doctor explained the reasoning behind their rating
The Industrial Commission has the final word on what the rating is, and must approve every rating before the injured worker receives any compensation for permanent disability.
Beyond the Impairment Rating: Other Options
You may have many questions when you are told by your doctor that you are at the end of your healing period and have a rating. One question may be how much money you will get for the damage to your body and for the lost of your wages.
While your impairment rating is important, it’s not the only way to receive compensation for a work injury. If your injury affects your ability to earn wages, you may have additional options:
Temporary Total Disability Benefits
If you cannot work at all because of your injury, you may receive temporary total disability benefits equal to two-thirds of your average weekly wage, for up to 500 weeks. If you cannot earn wages after 500 weeks, you can get benefits if you have a total loss of wage earning ability.
Wage Differential Benefits
If you can work but earn less than before your injury, you might qualify for benefits that cover two-thirds of the difference between your pre-injury wages and your current earning capacity, for up to 500 weeks from the date of injury.
Choosing the Best Option
In many cases, injured workers have a choice between accepting their impairment rating payment or pursuing ongoing disability benefits based on wage loss. The best choice depends on your individual circumstances, including your:
- Current health condition
- Ability to work
- Pre-injury wages
- Future medical needs
- Age and education
- Job prospects
How a Workers’ Compensation Attorney Can Help
Understanding impairment ratings and their impact on your case can be challenging. At Johnson & Groninger PLLC, we can help you:
- Determine if your impairment rating is fair and accurate
- Decide whether to seek a second opinion
- Calculate the value of your permanent partial disability benefits
- Compare the value of your rating to other available benefits
- Navigate the workers’ compensation system to maximize your recovery
Talk to an Attorney About Your Workers’ Comp Impairment Rating
If you’ve received an impairment rating or are approaching maximum medical improvement, it’s a critical time in your workers’ compensation case. The decisions you make at this stage can significantly impact your financial recovery.
At Johnson & Groninger PLLC, we’ve helped many North Carolina workers navigate the complexities of impairment ratings and secure the benefits they deserve. Contact us for a free consultation about your workers’ compensation claim.
The information in this blog post is general in nature and should not be considered legal advice for your specific situation.