Have you ever heard of an impairment rating scale?
When you get hurt at work, your employer may be responsible for paying some of your expenses while you cannot work. This could include lost wages and medical bills. We call this worker’s compensation. This money does not come directly from your employer but from their insurance company.
The state of Louisiana requires most employers to carry worker’s compensation insurance. Sometimes, the insurance company your employer has insurance with will offer you a settlement. This means that you will get one lump sum of money rather than monthly benefits. You take this settlement in exchange for waiving your claim to benefits in the future. This settlement depends on an impairment rating, which your treating physician decides.
In this post, our worker’s compensation experts at Gordon & Gordon will answer all your questions about the impairment rating scale.
What is the Impairment Rating Scale?
Before we get into specifics about impairment ratings, let’s talk about what part this scale plays in the worker’s compensation process.
It is helpful for employers and insurance companies to determine the severity of an employee’s injury. Some of the key questions during a Louisiana worker’s compensation claim are:
- Is the employee unable to return to work because of their injury?
- Can the employee return to some other type of work, such as light-duty work?
To determine what is in its best interests, an insurance company will seek to assign an impairment rating to an employee.
When an insurance company seeks out an impairment rating, it is because they are going to offer a settlement to the employee. To know the size of the settlement they should offer, the insurance company has to answer those two questions above. When answering these questions, being able to place a numeric rating on the employee’s injury is extremely useful.
For this reason, insurance companies use an impairment rating scale.
What Is An Impairment?
We’ve talked about what an impairment rating is and why it is useful in a worker’s compensation case. We’ll also briefly discuss what Louisiana law considers an impairment.
Louisiana law defines impairment as a medical problem that affects the employee’s bodily functioning. The impairment must also prevent the employee from using their body in the way they did before the injury.
An impairment could be:
- Physical or mental in nature
- Caused by an injury or illness
- Permanent or temporary
- Severe or mild
How Does the Impairment Rating Scale Work?
As we talked about earlier, impairment ratings provide an estimate of an employee’s physical and mental health.
Doctors will assign impairment ratings on a sliding scale of 0 to 100.
There are different ratings for an injured body part and then for the body as a whole. Your arm may have a high impairment rating, meaning the injury is very severe. But if the rest of your body is healthy, your whole body impairment rating may be smaller.
The goal of the impairment rating scale is so the insurance company can determine if you will return to work. If you cannot return to work, the insurance company may seek to give you a settlement. Thus, if your impairment rating is particularly high, the insurance company may offer you a settlement.
When this becomes the case, the insurance company will negotiate a settlement based on your former wages, as well as your age.
What is Maximum Medical Improvement?
In a worker’s compensation case, you’ll hear the term “maximum medical improvement” or MMI thrown around a lot. In many cases, doctors will not assign an impairment rating until you reach MMI.
What this means is that you must reach a point where further treatment will not improve your situation. There aren’t surgeries or medicines that will make you more able to return to work.
What is the Difference Between Impairment and Disability?
In some cases, there isn’t any difference between impairment and disability. In fact, some states refer to the impairment rating scale as the disability rating scale.
But in Louisiana worker’s compensation, impairment and disability are not always the same.
Above, we listed the definition of an impairment as a medical condition. Impairment refers to the loss of functionality in the body; it refers to the actual injury.
Disability, alternatively, is a legal term that refers to the employee’s ability to return to work. When an employee sustains a total or partial disability, it does not necessarily mean they have a disability in the physical sense. In this context, disability means they cannot return to their old job.
For example, let’s say that somehow, an office worker and a warehouse worker sustain the same back injury. Because they have the same injury, they have the same impairment. They have both lost the same level of functionality in the same part of their body.
But if the office worker can return to work, he does not have a disability in the legal sense. It is entirely possible for an office worker to do their job with minimal recovery after a back injury. Therefore the office worker may have an impairment, but not a disability.
The same is not true for a warehouse worker, who may engage in heavy lifting frequently in their job. With the exact same impairment, the warehouse worker may also have a disability. The warehouse worker will most likely receive different benefits.
The Impairment Rating Scale and Louisiana Worker’s Comp Settlements
Most Louisiana worker’s compensation claims don’t require impairment ratings. If the insurance company plans to simply pay out monthly benefits, they don’t need an impairment rating. When an insurance company seeks out an impairment rating, it is because they are considering a settlement.
The insurance company will use this impairment rating during settlement negotiation.
It’s also important to remember that other states require impairment ratings more frequently than Louisiana. When you are dealing with an insurance company that operates in multiple states, they may require an impairment rating whether Louisiana does or not.
Contact Gordon & Gordon
Insurance companies will use the impairment rating scale to justify the settlement they are offering you. But how do you know if that settlement is what’s best for you?
That’s where we come in. Gordon & Gordon have extensive experience in negotiating worker’s compensation claims. For more information about impairment ratings and insurance settlements, call Gordon & Gordon at 318.716.HELP. You can also leave us a message on our website.