When a person faces an injury or health condition that disrupts their daily life, they must deal with terms such as impairment and disability. These are crucial in understanding how injuries are assessed, and aid is determined, but they do not mean the same thing. Their distinction is necessary for medical evaluations and legal decisions in work-related injuries or long-term health conditions. You should understand how these terms differ because they impact the outcome of your compensation claim.
What are Impairment Ratings?
Impairment refers to a medical condition that health professionals can objectively determine using standard guidelines, like those from the American Medical Association (AMA). For example, a doctor may issue an impairment rating if an MRI shows soft tissue damage. This rating is a percentage that speaks to the severity of the impairment based on standardized criteria, indicating how much a specific body function is reduced. The impairment rating, however, is just a starting point.
It doesn’t directly dictate the disability benefits a person might receive because it doesn’t account for how the impairment affects an individual’s capacity to work or perform daily activities. For instance, a 2% impairment rating for a shoulder might not seem significant, but for someone whose job involves lifting or reaching overhead all day, this could significantly impact their ability to work.
This rating is determined using the AMA Guide’s percentage impairment, which provides a structured way to evaluate the severity of an impairment. It’s important to note that these ratings are purely medical and do not consider the individual’s employment situation. Therefore, while a doctor may assign a small percentage to an impairment, the practical effects on the person’s daily work life could be much more significant.
Let’s Discuss Disability Ratings
Disability ratings, on the other hand, are used to assess how an impairment affects an individual’s ability to perform their work. Unlike impairment ratings, disability considers the individual’s job requirements, skills, and other personal factors. This is where workers’ compensation cases often bring in additional assessments like Independent Medical Evaluations (IMEs). If an insurance doctor’s impairment rating seems too low given the job demands, an IME might be sought to argue for a higher disability rating.
For instance, if an IME costs $1500 but could potentially increase a settlement by thousands, it might be a worthwhile investment. Workers’ compensation and other disability systems will consider these evaluations along with the impairment rating to determine the appropriate level of compensation. Insurance companies may initially offer a settlement based on the lower impairment rating. Still, an IME can provide a different, possibly higher, disability rating that better reflects the person’s job-related challenges. This often leads to negotiations for a higher settlement amount. In some cases, the difference between the impairment rating and the disability compensation can be substantial, reflecting the medical condition and how it practically affects your work and earning potential.
Contact a Lawyer & Get Help with Your Claim
Understanding the difference between impairment and disability ratings and how they affect compensation can be challenging without professional guidance. If you are dealing with a work-related injury and are navigating through your compensation claim, it’s essential to have someone who can help clarify these terms and ensure you receive a fair assessment. Schedule a consultation today to discuss your case and explore your options for a just resolution.
Pati Law Firm
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