When a work injury or condition causes a permanent change in an employee’s health or ability to work, workers may be entitled to potentially significant Permanent Disability benefits. Because the employer assigned doctor often fails to document all the effects of an injury, workers may not receive the Permanent Disability benefits they deserve. Thomas F. Martin is a leading workers’ compensation attorney in Orange County dedicated to helping workers obtain the evidence they need to prove the extent of their injury, and the true level of their permanent disability.
What is Permanent Disability?
According to the State of California Department of Industrial Relations, “Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living.” Workers who have sustained a permanent disability are entitled to benefits even if they are able to go back to work.
How Are PD Benefits Determined?
In California, PD benefits are determined by:
- The date of their industrial injury
- The worker’s primary treating physician or a qualified medical evaluator (QME) will conduct an examination to determine their impairment level, or the extent to which the worker’s injury impacts their ability to work
- The worker’s impairment level will be expressed as a percentage
- A formula will use the worker’s impairment percentage, age and occupation to calculate how much PD the worker is entitled to receive
A workers’ compensation lawyer will help injured workers understand how much PD benefits they may be entitled to and help the worker receive the maximum benefits available to them.
What’s Included in a Doctor’s Report?
A “permanent and stationary” report is created once a patient’s medical condition is not improving or worsening. This is the point at which the patient has reached maximum medical improvement (MMI). The report will describe the workers’:
- Specific medical problems, such as how much pain they are experiencing and movement restrictions
- Work restrictions
- Medical care needs
- Ability to return to their previous job
The report will also include an estimate of how much of the disability is caused by the job, compared to how much of the disability is caused by other factors.
The P&S report will affect the worker’s future benefits and workers have a right to receive a copy of it. They should make sure they understand the contents of the report and should report any mistakes or omissions.
How to Dispute the Doctor’s Report
Workers who disagree with the doctor’s evaluation of their disability status should contact the claims administrator to obtain a DWC form and request a panel of three QMEs. Workers have ten days to select one QME from the panel, schedule an appointment to be examined by the QME and inform the claims administrator of which QME they chose and when the examination will be conducted.
It’s important for workers to have an experienced workers’ compensation attorney to walk them through the process and make sure each step is properly executed. A workers’ compensation attorney will communicate with the claims administrator to select a doctor to resolve medical disputes, called an agreed medical evaluator (AME).