Impairment Ratings for Workers’ Compensation Cases

Workplace injuries are more common than many realize. According to the U.S. Bureau of Labor Statistics in 2022, private industry employers reported 2.8 million nonfatal workplace injuries and illnesses. When a worker suffers serious injuries, determining the extent of the damage is crucial — not just for fair medical treatment but for calculating compensation.

If you’ve filed a workers’ compensation claim in North Carolina, you may hear your doctor or insurance carrier mention an “impairment rating.” Understanding what this rating means and how it affects your benefits can significantly protect your rights.

In this guide, we walk you through the impairment rating process, how it’s determined, and why working with an experienced workers’ compensation lawyer is vital.

What are impairment ratings in workers’ compensation?

Think of an impairment rating as a permanent damage report for your body after a work injury. It’s a medical assessment that measures how much function you’ve lost in specific body parts due to an accident.

In North Carolina, these ratings are used to calculate your permanent partial disability (PPD) benefits. The greater the impairment, the more significant the compensation. That’s why every injured worker should know what an impairment rating means and how it’s used to decide how much money they deserve.

When and why are impairment ratings assigned?

You won’t get an impairment rating the day after your accident. Instead, it comes after you hit Maximum Medical Improvement (MMI), when doctors agree you’ve recovered as much as you’re ever going to.

At that stage, your physician (or a doctor chosen by the insurance company) assigns a percentage rating based on how your injury affects your daily life and future function. This rating matters because it directly impacts the amount and duration of workers’ compensation benefits you can collect.

This is where insurance companies may play games to minimize payouts. Advice from a good workers’ compensation lawyer is invaluable.

How medical professionals determine an impairment rating

Assigning an impairment rating isn’t just a quick guess. Medical professionals thoroughly examine how your injury affects your strength, range of motion, and everyday activities. They may use standardized tools like the AMA Guides to Evaluation of Permanent Impairment to ensure the rating is consistent and fair.

The doctor may run physical tests, order imaging studies, and assess chronic pain or nerve damage. From there, they calculate a percentage representing a lasting loss of function. For example, losing 25% of the movement in your shoulder may equal a 10% impairment rating for your entire arm.

Sounds clinical, right? That’s why having a workers’ compensation lawyer who understands this process’s medical and legal sides can make a significant difference, especially if your rating seems suspiciously low.

Examples of common permanent injuries and ratings

Some injuries have predictable impairment ratings. Here’s a snapshot of what you may expect if you’re unlucky enough to deal with one of these:

• Thumb amputation. This is usually rated around 40% impairment of the hand, which is significant considering how much we rely on opposable thumbs.
• Herniated spinal disc. If you’re left with chronic pain and symptoms, you may see a 10 to 20% rating for the spine.
• Frozen shoulder. Limited movement in the shoulder could net a 20% to 25% rating of the upper extremities.
• Severe knee injury (like an ACL tear with surgery). This often results in a 10% to 20% impairment rating of the leg.
• Traumatic brain injury (TBI). Even mild TBIs can carry a 15% to 25% impairment rating if they cause lasting cognitive or neurological problems.

These are ballpark figures. Every case is different, and insurance companies are notorious for underrating injuries. When that happens, a keen workers’ compensation lawyer can help you fight for the actual value of what you’ve lost.

How impairment ratings can impact your workers’ compensation benefits

Your impairment rating isn’t just a number on a medical sheet; it’s the currency of your workers’ compensation benefits in North Carolina. The higher the rating, the more weeks of benefits you’re entitled to under the state’s workers’ compensation settlement system.

For instance, say you injure your hand and North Carolina law says a total hand loss equals 200 weeks of benefits. If your impairment rating is 10%, you’d be eligible for 20 weeks of payments.

Here’s the catch. Even a small error in your rating (like being assigned 5% when you deserve 15%) can cost you thousands of dollars. That’s why it’s smart to have a workers’ compensation lawyer double-check every calculation when settlement time comes around.

Can an impairment rating be challenged or changed?

Absolutely. You are not stuck with the first impairment rating you receive.

If you believe your doctor undervalued your injuries or if new symptoms develop, you can request a second opinion, known as an independent medical examination (IME). If the new evaluation supports a higher rating, you can appeal to the North Carolina Industrial Commission for a formal review.

Disputes over impairment ratings are common, and insurance companies often resist paying more. That’s when a skilled workers’ compensation lawyer can help you gather evidence, organize medical records, and present a strong case for better benefits.

Why do you need a workers’ compensation lawyer to protect your rights?

Let’s be blunt. The workers’ compensation system isn’t designed to favor injured employees. Insurance companies are businesses, and businesses love saving money by minimizing payouts.

A good workers’ compensation lawyer acts as your shield and sword. They can:

• Ensure your impairment rating is calculated correctly.
• Push back if the insurance company tries to lowball your settlement.
• Guide you through disputes, appeals, and hearings, if necessary.
• Ensure you receive every dollar you are entitled to under the law.

Without a knowledgeable advocate, accepting a settlement worth less than your injury is too easy. Don’t risk it — your health, finances, and future are too important.

If you’ve suffered a workplace injury, protect your future by speaking with the experienced workers’ compensation lawyers at Price Petho & Associates.