Workers who were injured while doing construction work, retail work, hospital work, or any type of work have the right to get the best health care available to treat their injuries. Many injured employees need to treat with their doctors for months or longer before they begin to see improvement. Some workers are fortunate to return to their old job. Many workers need to work to work with medical restrictions.
Injured workers have the right to be compensated for their injuries (typically at a 2/3rds rate) until they reach maximum medical improvement (MMI) – the point where additional medical care won't improve their health. When they reach MMI, workers have the right to have their treating doctor assign a permanent partial disability rating. The worker is entitled to this rating if they haven't returned to work – and even if they have returned to work.
Impairment ratings are authorized by the North Carolina Workers' Compensation Act. Once the rating is assigned, the worker can request a lump sum payment for lost wages based on the impairment rating. The worker will still be entitled to have the employer's insurance company pay their medical bills so their health doesn't get worse – provided they comply with the necessary formalities.
Impairment ratings are set forth in North Carolina Statute 97-31. that most workers are entitled to for up to 500 weeks – provided they are unable to return to work.
A common misconception is that the permanency or impairment ratings are very important in valuing a worker's comp settlement. Many times, that is not the case. If one is unable to return to his or her occupation due to the work injury, then that is certainly not true. Impairment ratings are only relevant in terms of settlement discussions in cases where the injured worker has RETURNED TO WORK at the same or higher wage as the pre-injury job. This is because in those circumstances, his or her ongoing benefits would have ceased, so that all that remains would be the weeks the worker would be entitled to based on the impairment ratings.
If the injured worker is unable to return to his or her occupation, in most cases, the impairment rating is not relevant to settlement discussions. This is because one cannot get more than 500 weeks of benefits except in rare cases. The ratings cannot ADD to the 500 weeks and one cannot get ratings money at the same time one is getting weekly checks for workers comp.
So, what becomes relevant in a case where a worker cannot return to his or her job is how many weeks remain of the maximum allowable weeks of 500 weeks. Usually, the impairment ratings, unless there are extremely severe injuries to multiple body parts, are not going to come anywhere close to the remainder of the 500 weeks. So that number—the number of remaining weeks of the 500 weeks times the weekly workers comp check—becomes the most relevant number when discussing a settlement of the claim.
The worker should review with an experienced North Carolina work injury lawyer whether his or her case fits into the category of a matter that falls under a ratings-type case or a disability-from-work claim. There are other considerations that the lawyer will review such as the need to look for alternative work if you've reached MMI. If you're not careful, you may even lose your weekly benefits if you don't follow the correct procedures.
Workers who are likely to return to work soon, or have returned to work at the same or higher watges and don't anticipate much additional medical care would be more likely to be accepting an impairment rating payout as part of any settlement.
Your treating doctor will review whether you have an injury that is listed in the North Carolina impairment statute. If you do, the physician will then determine the severity of your injuries based on North Carolina Industrial Commission standards or standards established by the American Medical Association. The rating examines whether you have lost the full use of an arm, for example, or whether you some limited ability to use the arm. Ratings today are typically done through Functional Capacity Examinations (FCE's). The treating doctor merely signs off on those ratings. If the treating doctor's rating seems wrong, workers can request a second opinion at the employer's insurance company's expense.
For example, the loss of hearing is paid at 2/3 rds of your average weekly wages for 70 weeks for the loss of hearing in one ear. The amount rises to 2/3rds of your average weekly wage for 150 weeks for the loss of hearing in both ears.
So, if you were earning $900 a week, your comp rate would be $600.00. If you lost hearing in one ear, the doctor will assess the degree of loss. If the impairment rating is 30% for hearing loss in just one ear, that would be 70 weeks x .30 or 21 weeks. Then your payout would be $600.00 x 21 weeks or $12, 600.
The North Carolina statute assigns the following ratings losses for some injuries. The statute contains the full list:
§97-31. Schedule of injuries; rate and period of compensation.
In cases included by the following schedule the compensation in each case shall be paid for disability during the healing period and in addition the disability shall be deemed to continue for the period specified, and shall be in lieu of all other compensation, including disfigurement, to wit:
1. For the loss of a thumb, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 75 weeks.
2. For the loss of a first finger, commonly called the index finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 45 weeks.
3. For the loss of a second finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 40 weeks.
4. For the loss of a third finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 25 weeks.
5. For the loss of a fourth finger, commonly called the little finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 20 weeks
6. The loss of the first phalange of the thumb or any finger shall be considered to be equal to the loss of one half of such thumb or finger, and the compensation shall be for one half of the periods of time above specified.
7. The loss of more than one phalange shall be considered the loss of the entire finger or thumb: Provided, however, that in no case shall the amount received for more than one finger exceed the amount provided in this schedule for the loss of a hand.
8. For the loss of a great toe, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 35 weeks.
9. For the loss of one of the toes other than a great toe, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 10 weeks.
1 The loss of the first phalange of any toe shall be considered to be equal to the loss of one half of such toe, and the compensation shall be for one half of the periods of time above specified.
1 The loss of more than one phalange shall be considered as the loss of the entire toe.
For the loss of a hand, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 200 weeks.
For the loss of an arm, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 240 weeks.
1 For the loss of a foot, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 144 weeks.
1 For the loss of a leg, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 200 weeks.
1 For the loss of an eye, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 120 weeks.
Back injuries sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 300 weeks.
Additional injuries covered include:
· The loss of both hands, or both arms, or both feet, or both legs, or both eyes, or any two thereof,
· Total loss of use of a member or loss of vision of an eye shall be considered as equivalent to the loss of such member or eye.
· In case of serious facial or head disfigurement, the Industrial Commission shall award proper and equitable compensation not to exceed twenty thousand dollars ($20,000).·
Other injuries and conditions apply.
If you have additional questions regarding impairment ratings, or any other issue pertaining to North Carolina or Virginia Workers Compensation, please do not hesitate to contact us at Joe Miller Law. Remember that depending on the case, impairment ratings can be rendered really unimportant if you are unable to return to work. Then, the issue becomes your ongoing disability checks. This is because unless you are permanently and totally disabled from all work, you will be limited to a maximum benefit amount of 500 weeks. Your impairment ratings will not add to that maximum amount. But that is a subject for another article.