This post discusses Disability Ratings in NC Workers' Compensation cases. A rating is an integral part of any settlement discussion in workers' compensation, but what is it? Who makes this rating and when does it happen?
What is a NC Workers' Comp Disability Rating?
Your disability rating is a percentage loss in functionality of the injured body part. In simple terms, the rating represents how your injury has permanently affected your body. For example, if you broke your leg at work and it heals, there still may be some permanent loss of function to your leg. In addition, there may be scarring or other residuals that affect your ability to earn wages in the future.
In accepted Workers' Comp claims, your "authorized treating physician" will determine if you have any permanent disability after you have reached what is called "maximum medical improvement" or sometimes abbreviated as MMI. Maximum medical improvement occurs when you have finished all relevant medical treatment and further improvement is not expected. Your "authorized treating physician" will be a doctor selected by the workers' compensation insurance carrier.
In denied claims, the workers' compensation insurance company has denied that you have a workers' comp case, so medical treatment is paid for by the injured employee themselves unless they win their case at hearing before the North Carolina Industrial Commission (NCIC). After you win your claim for workers' compensation benefits and after your own treating physician says you have reached MMI, a determination of permanent disability will be made.
How is the NC Workers' Compensation Disability Rating determined?
North Carolina differs from many other states in that the disability ratings are statutory by body part. (see N.C. Gen. Stat. § 97-31 ). However, the amount of the rating is left largely to the experience of the provider and can vary from one doctor to another based on experience with workers' compensation cases, although the N.C. Industrial Commission Rating Guide is available.
As a common sense matter, a physician that is paid by the workers' compensation insurance company may find that you have a lower impairment rating. Seeking a 2nd opinion can be helpful for an injured employee.
Disability ratings in NC Worker's Compensation also have special rules for amputation of toes and fingers, as well as for eyes, and for hearing loss. Compensation for scarring is limited and usually is only for serious scarring or dis-figuration to the face or head. Ratings for other body part scarring is discretionary based on how much interference the scarring causes with your ability to earn wages. There is limited compensation for injuries to muscles and internal organs, and any compensation for soft tissue injury is largely at the discretion of the Industrial Commission.
How is my compensation determined by my disability rating?
The below is a hypothetical example and may not apply to your specific situation or the facts of your claim. That is why it is important to discuss your case with a NC Workers' Compensation attorney so you understand the settlement options available to you.
If hypothetically, let's say that your treating physician has determined that you have a 15% permanent impairment from your workplace low back injury and before your were injured you made $1,000 per week. If your claim was accepted, and you wanted to keep working for your employer after the case is over, then you might calculate your compensation as follows:
For the total loss of use of the back, benefits are sixty-six and two-thirds percent (66 2/3%) of the average weekly wage of $1,000 for the statutorily allowed 300 weeks; which in our example is equal to $200,001. However, in our hypothetical example you only have a 15% loss of functionality and not a total loss, so your 15% rating to your back would value your compensation at $30,000.15. As you can imagine, the process can be complex and if you have injured more than one body part, the analysis gets even more complex.
For a denied claim, your settlement may be different and you should consult with a NC Workers' Compensation attorney. Understanding disability ratings in NC workers' compensation is complex, but with the help of a NC Workers' Compensation attorney , you can better understand how your disability rating affects your claim.
The Bishop Law Firm represents injured workers with NC Workers’ Comp claims in Raleigh, Cary, Fayetteville, Durham, Rocky Mount, Wilson, Smithfield, Louisburg, Chapel Hill, Roanoke Rapids, and surrounding areas in North Carolina. We do not get paid unless we win your case, (919) 615-3095. Call us today!
