Posted on Monday, September 23rd, 2019 at 11:06 am
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 – 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:
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:
Additional injuries covered include:
Other injuries and conditions apply.
Virginia and North Workers’ Compensation Lawyer Joe Miller Esq. has helped thousands of injured workers get the full workers’ compensation benefits they deserves. He works with the treating doctors and independent doctors to properly assess your medical condition. He’ll detail how much money you will get if you continue on disability or if you settle your claim in a lump sum. To speak with an experienced work injury lawyer, call attorney Joe Miller at 888-667-8295. or complete my contact form to make an appointment.