What is an impairment rating?
In a SC workers’ compensation case, the treating doctor will usually give an impairment rating once the claimant has reached maximum medical improvement. What that means is that the doctor has determined that the person is as good as they are going to get with treatment. The doctor will then give an impairment rating which is based on the AMA Guides to the Evaluation of Permanent Impairments. This is a guide created by the American Medical Association for doctors to evaluate how much permanent damage your workplace injury has caused. This is divided by body part. For example, you might be determined to have a 10% impairment to the left leg. You can find out more about the AMA Guides HERE.
Will I get a fair impairment rating from the doctor hired by the insurance company?
However, keep in mind that the doctor which has been picked by the insurance carrier may issue lower impairment ratings. The AMA guides are subject to interpretation and a more conservative interpretation by the doctor results in a lower rating. It also depends on which AMA edition is used. Using the 6th edition often leads to the doctor issuing lower impairment rating than using the 5th edition. You can find out more about this issue which is discussed in more detail HERE. Insurance carriers and their lawyers are more likely to pick doctors that routinely give lower impairment ratings to the claimants. The insurance company’s goal is usually to get the lowest settlement amount they can. If accepted, a low impairment rating from a doctor that does not show the full extent of your injuries could have a negative impact on your case. This is because the impairment rating is taken into account by the Commissioner in calculating your final disability rating.
Is there anything I can do if I feel that the impairment rating given by my doctor is too low?
There are a couple of things that can be done. First, you can ask for a second opinion from the insurance company. However, the problem with this is that the insurance company is likely to pick another doctor that routinely gives low impairment ratings. You can also request an independent medical evaluation from another doctor. However, it is important to note that these doctors often charge for these evaluations. These charges vary but it can be more expensive if you are looking for a medical evaluation from a specialist. An experienced workers’ comp attorney may able to help here especially if they know doctors that will give a fair evaluation of your medical problems.
Is my final disability rating different from my impairment rating?
The final disability rating assessed to your injuries takes the impairment rating into account. However, it does not entirely account for your final disability rating. This rating can be calculated based on your age, your educational level, and the work that you performed in the past among other levels. For example, a 10% impairment to the left leg will have a greater impact if you have only ever done work that involves standing and walking all day. It will probably have less impact on a person who has performed work where they are sitting most of the day. The final percentage will be determined by a South Carolina Workers’ Compensation Commissioner if your case goes to a hearing.
How will my final SC workers’ compensation settlement check be calculated?
In our example involving a 10% impairment to the left leg, let’s assume that this was a worker who worked at a factory job and assembled parts. The worker was standing and walking most of the day. As a result, the Commissioner awarded a 20% disability rating to the left leg. SC Law 42-9-30 states that workers can get up to 195 weeks of compensation for the total loss of a leg. You can find out more about compensation values HERE. In this example, you would be entitled to 39 weeks of compensation at a 20% disability rating. This would be multiplied by your compensation rate (which is 66 2/3% of your average weekly wage) to get your final settlement check. For example if you were making $600 a week, you would be entitled to a compensation rate of $400 per week. This compensation rate is multiplied by 39 weeks to get a final settlement check of $15600.
Disclaimer: The information in this blog post (“post”) is provided for general informational purposes only, and may not reflect the current law in your jurisdiction. No information contained in this post should be construed as legal advice from Pati Law Firm, or the individual author, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this Post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.
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