What is My Degree of Disability?

In workers’ compensation your degree of disability is a very important number. It explains, in percentages, how disabled you are from a medical perspective. That number is then used to determine how much money you will receive per week from workers’ compensation.

A healthy person with no injuries, conditions or illnesses is 0% disabled. A person with a new, serious injury or someone recovering from a recent surgery is usually 100% disabled, which means they can’t return to any type of work at the present time. For workers’ compensation purposes the person who is 0% disabled receives no benefits and the person who is 100% disabled receives a total rate. There is also a difference between temporary disabilities and permanent disabilities. When you are first injured your disability is considered “temporary.” As you heal, your level of disability might decrease because you are getting better. So while you might be 100% disabled the day after your accident, in six months you might only be 50% disabled. After some time has passed your doctor might say that you have reached “Maximum Medical Improvement” (MMI) which means that you aren’t going to get any better. At that point your doctor might give an opinion about your level of “permanent” disability, meaning a disability level that is not expected to change over time.

Your degree of disability is determined by a doctor using his or her medical judgment, your physical exam and diagnostic tests (MRIs, CT Scans, X-Rays, etc.). Sometimes the doctor will reflect your disability level as a percentage such as 25%, 33%, 50%, etc. But other times, a doctor might use words like “mild,” “moderate,” “marked” or “total.” Workers’ Compensation Judges understand those words to stand for certain levels of disability. For instance, mild usually means 25% disabled; moderate usually means 50% disabled; Marked usually means 67% disabled and total obviously means 100% disabled.

Whatever your degree of temporary disability, that is the percentage of your rate that you will receive until your permanent loss of wage earning capacity is determined, which does not happen until you reach maximum medical improvement. For instance, if your total rate is $500 and you are 100% disabled you will receive $500. But then, let’s say you start getting better and your doctor says you are only 50% disabled. Then your rate will be decreased 50% to $250.

Sometimes doctors disagree about your degree of disability. Often, the workers’ compensation carrier will request that you be evaluated by an Independent Medical Examiner (IME). That is a doctor hired by the workers’ compensation carrier to assess your degree of disability and the causal relationship of your accident. When the IME doctor disagrees with your treating doctor, that can cause problems for your workers’ compensation case. The Workers’ Compensation Board does not automatically side with either doctor. Sometimes, testimony must be taken of the doctors and legal briefs written to help the judge determine which doctor is right. In situations like that, having a lawyer to represent you becomes very important as the workers’ compensation carrier is represented by an experienced lawyer who knows what to ask for. You need someone on your side with experience questioning doctors and knows what to look for to help you get as much as you deserve. Segar & Sciortino has years of experience deposing doctors in workers’ compensation cases. If your rate has been decreased because an IME doctor disagreed with your treating doctor, give us a call.