If you were injured in a workplace accident, you might have heard the term “injury rating” thrown around. If you’re like most inured employees, you have no clue what this term means and how it affects your workers’ compensation benefits. Unfortunately, the answer isn’t simple, but our attorneys are here to help guide you and answer any questions you have throughout the process.
What does “injury rating” mean?
An injury rating refers to a permanent injury after a workplace accident. Someone who has a permanent injury is an individual that has reached Maximum Medical Improvement and still has an impairment from the workplace injury. The injury rating is the physician’s attempt to assign a numerical value to the impairment.
Under North Carolina work’s compensation laws, an employee who suffers a permanent injury to certain body parts is entitled to permanent partial disability benefits. The body parts eligible for disability benefits include:
- Eyes (including loss of vision)
- Ears (including hearing impairment)
- Back or spine
There are also circumstances in which an injured employee may receive payments for serious disfigurement or injury to internal organs.
These partial disability benefits are available regardless of whether you lost wages from the injury. It is considered compensation for the loss or permanent injury to a body part, meaning that your claim for permanent partial disability benefits may be in addition to a claim for lost wages related to the workplace injury.
How are disability benefits calculated?
The calculation used for permanent partial disability benefits has multiple factors. The first of these factors is the injury rating. When the injured employee has made as complete of a recovery as possible, the physician treating the employee will assign a disability rating to the injured body part.
The rating represents the percentage of permanent damage to the injured body part and is generally guided by the North Carolina Industrial Commission’s Rating Guide. This rating is then plugged into an equation to determine the compensation provided to the injured worker.
It’s important to note that most other states use the American Medical Association Guidelines when rating injuries. Since North Carolina has its own guidelines, it’s critical to have an attorney who is familiar with how the injury ratings work in this state.
Since the rating directly impacts the compensation an injured worker receives, it’s critical that the rating is appropriate to the disability sustained. Disability ratings may drastically vary depending on the physician providing the rating. Injured employees are entitled to get a second opinion on the rating they receive using a physician of their choosing at the employer’s expense. Often, the second physician will provide a higher disability rating as they are not evaluating the effectiveness of their own skills in aiding the injured employee’s recovery.
The other factors that go into the calculation for compensation include:
- The number of weeks assigned to the body part by North Carolina General Statute §97-31
- The injured employee’s compensation rate.
As you can see, the overall amount to which you are entitled is not only affected by the disability rating you receive but also by the compensation rate. The same disability rating will result in a higher payment if your compensation rate is higher. With that in mind, make sure to verify the compensation rate used to calculate your permanent partial disability to make sure it is accurate.
Before the injured employee receives any permanent partial disability payments, the benefits must be approved by the North Carolina Industrial Commission. Once approval has been received, most injured employees will receive a lump sum payment. In some circumstances, the benefit payments will be made on a weekly basis.
What happens once permanent partial disability rating payments are received?
It’s important to note that once your permanent partial disability benefit is paid, all other payments related to the disability (such as temporary disability payments under workers’ compensation) will cease. These permanent partial disability benefits will not end any medical benefits you may be receiving, however, although this does not necessarily mean that there has been a full and final settlement with your employer for your injury.
Injured employees also need to keep in mind that there is a two-year time limit from the date of the permanent partial disability rating payment to file a change in condition with the North Carolina Industrial Commission. A change of condition claim occurs if the injury in question gets substantially worse. If the injured employee does not file a change of condition claim and the accompanying documentation of the worsening injury or condition within that two-year period, the employee may waive the right to additional benefits.
Do you have to accept the permanent partial disability rating payments offered?
No. Injured employees are allowed to choose the remedy that they feel is best for their situation. In some cases, accepting permanent partial disability rating payments may not be in their best interest. An experienced workers’ compensation attorney can help you evaluate the options available and determine the most beneficial course of action.
- What Are the Benefits of Hiring a Workers’ Compensation Lawyer?
- North Carolina Industrial Commission
Contact an Experienced North Carolina Workers’ Compensation Attorney
Figuring out the best course of action when dealing with a permanent partial disability due to a workplace injury can be complex. Don’t deal with it alone. Our attorneys have extensive experience with workers’ compensation claims. They can help you evaluate the options available to you and make sure that you take advantage of your rights under North Carolina law.
Contact Horton & Mendez for a free, no-obligation case review. We’ll review your case with you and provide honest feedback and guidance. Our goal is to provide you with helpful information that will allow you to make the best decision for you and your family. And remember, we do not charge a fee unless you receive compensation.