What is Permanent Disability?
Permanent Disability benefits are designed to compensate employees who have sustained permanent functional impairments or limitations as a result of their work-related injuries. Unlike Temporary Disability benefits, which are meant for short-term recovery, PD benefits address long-term or lifelong disabilities.
Determination of Permanent Disability
The determination of Permanent Disability involves several steps and factors:
Medical Evaluation:
Primary Treating Physician (PTP): The initial assessment is usually made by the employee's primary treating physician, who evaluates the extent of the injury and the level of permanent impairment.
Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME): If there is a dispute or if more detailed evaluation is needed, the employee may be referred to a QME or AME, who provides an independent medical assessment.
Disability Rating:
The degree of Permanent Disability is expressed as a percentage, representing the extent of the impairment and its impact on the employee’s ability to perform work-related tasks.
Rating Formula: The percentage is determined using the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, which are adjusted by factors including the injured body part, the employee’s occupation, and their age at the time of injury.
Rating Formula
Permanent and Stationary (P&S) Report: Once the medical condition has stabilized and is unlikely to improve significantly (reaching a status known as Permanent and Stationary), the treating physician prepares a P&S report.
This report outlines the level of permanent impairment and any work restrictions that may be necessary.
Permanent and Stationary (P&S) Report:
Once the medical condition has stabilized and is unlikely to improve significantly (reaching a status known as Permanent and Stationary), the treating physician prepares a P&S report.
This report outlines the level of permanent impairment and any work restrictions that may be necessary.
Disability Rating Schedule (DRS):
The Disability Rating Schedule is used to convert the medical impairment rating into a PD percentage. This schedule considers the nature of the injury, occupation, and other factors to provide a standardized rating.
The final PD rating is crucial in determining the amount and duration of PD benefits.
Benefits Calculation
The PD benefit amount is calculated based on the disability rating and the employee's pre-injury wages:
PD Rating Percentage: Determines the number of weeks of benefits the employee is entitled to receive.
Weekly Benefit Rate: This is typically two-thirds of the employee's average weekly wages, subject to minimum and maximum limits established by state law.
Payment Schedule: PD benefits are generally paid weekly until the total amount owed is fully disbursed.
Important Considerations
Apportionment: If part of the disability is attributed to a previous injury or condition, only the portion directly related to the work injury is compensated.
Vocational Rehabilitation: In cases where employees cannot return to their previous job due to their disability, they may be eligible for vocational rehabilitation services to help them find suitable alternative employment.
Disputes: If there is a disagreement over the PD rating or benefits, employees can request a hearing with the Workers' Compensation Appeals Board (WCAB) to resolve the issue.
Filing for Permanent Disability
Report the Injury: Ensure the injury is reported and documented through the workers' compensation claim process.
Medical Documentation: Follow through with all medical evaluations and ensure that all reports are comprehensive and accurate.
Legal and Administrative Support: Consider consulting with a workers' compensation attorney if there are complexities or disputes regarding the PD benefits.
Resources
For more detailed information on Permanent Disability benefits and how they are determined, please refer to:
- California Department of Industrial Relations - Permanent Disability
- California Workers' Compensation Institute - PD Benefits
- Guide to Workers' Compensation in California
This memo provides an informational guide to understanding Permanente Disability (“PD”) benefits under California's workers' compensation system and it is not intended as legal advice. For any specific legal advice or assistance, please contact our highly competent and knowledgeable attorneys.