A Pennsylvania worker who is injured or becomes ill on the job is entitled to workers’ compensation benefits assuming that all eligibility requirements are met. The type, extent, and duration of benefits depend on a variety of factors, including the worker’s impairment rating.
What Is an Impairment Rating?
In short, an impairment rating reflects the extent to which your body has been injured or “impaired.” A worker with an impairment rating of 50 percent or more is entitled to total disability payments, while a worker with an impairment rating of less than 50 percent is entitled to partial disability payments.
How Is My Impairment Rating Determined?
A doctor determines your impairment rating by using the American Medical Association Guides to the Evaluation of Impairment. In theory, determining your impairment should be an objective task. However, in practice there is a subjective aspect to the determination. Different injuries are assigned different percentages that reflect the amount of impairment to your body as a whole. If you suffered more than one injury, the percentages will be added together to calculate a total impairment rating.
Can My Impairment Rating Change?
Yes. There are several ways your impairment rating may change. If you are initially given an impairment rating that qualifies you for total disability benefits, your employer may request a medical examination after 104 weeks to determine whether your illness or injuries still qualify you for total disability. Likewise, if you have been receiving partial disability benefits and you subsequently obtain a new impairment rating from a qualified physician that rates you at 50 percent or higher, you can petition for total disability benefits.
Who Determines My Impairment Rating?
In most cases, you are allowed to choose your own physician when you suffer a work-related injury or illness. One exception to this rule is if your employer has approved your claim and has posted a list of six or more physicians for workers’ compensation claims in your workplace. In that case, you must initially see one of those listed doctors. After 90 days you may choose to receive treatment from another physician. You are also entitled to get a second opinion if invasive surgery is recommended by a listed physician within the 90-day period.
Although you may choose your own doctor for treatment, your employer is entitled to request an evaluation from a doctor of its choice while you are receiving workers’ compensation benefits. Your employer may even petition a court to order the evaluation. Failing to comply could result in suspension of your benefits.
Your impairment rating is a crucial component of your Pennsylvania workers’ compensation benefits claim. During the entire claims process you have the right to make choices and appeal decisions that you do not agree with; however, you must understand your rights in order to assert them.
Although the workers’ compensation system is intended to protect injured workers, it can be difficult to navigate. If you have questions or concerns about your legal rights to compensation, contact the Bulldog Lawyers at Shor & Levin by calling 855-860-8548 or by using our Worker’s Compensation.