Permanent Disability

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PERMANENT DISABILITY

Los Angeles Workers Comp

Permanent Disability

Sustaining a work-related injury is very common, and Los Angeles Workers Comp laws have been designed to protect employees, and to afford them with necessary compensation in order for them to overcome those injuries, along with the financial difficulties that arise as a result of their work-related injury. Injuries which may be sustained at the workplace vary, as does their severity. The type and amount of benefits that injured employees may receive depend largely on the type and severity of the injury.

If you have sustained a permanent disability as a result of an injury sustained at the workplace, this article shall provide you with the basic knowledge with respect to permanent disability as per the Los Angeles Workers Compensation law.

If you would like general insight on other topics related to workers’ compensation, you may contact one of our Los Angeles Workers Compensation Attorneys for a professional consultation and advice, or you may browse the content of our website for general California workers compensation information.

What is permanent disability?

When you have been injured, in most cases you hope that you will make a full recovery. This is unfortunately not always the case, and sometimes there is damage which is permanent and which you will never recover from. It may be expressed in different forms depending on the type of injury suffered, and may include lasting pain or other limitations. This is what is known as “permanent disability”, and it may be both physical or mental.

What are permanent disability benefits and how do I get them?

A physical injury in itself is an “injury to the body”, and thus sustaining such an injury while at work shall fall within the definition of a work-related injury and shall thus be compensable.

If, as a result of a work-related injury, you have a permanent disability, then you may be able to receive permanent disability benefits. In order for you to receive benefits for your permanent disability, you must have reached a stage called “maximal medical improvement” (MMI) or “permanent and stationary” (P&S).

In order to prove that you have reached this stage, you must provide a report written by your doctor which states that your recovery has reached a point which will not be exceeded, and that it is unlikely to get better within the next year, regardless of whether you continue your medical treatment or not.

What happens when I reach MMI/P&S?

If you have received temporary disability payments, those payments will stop. This is due to the fact that you have now made a recovery as far as possible. If that means that you can go back to work and you have made a full recovery, then you will not be eligible for permanent disability benefits. However, if there are still some mental or physical limitations remaining as a result of your injury, then you might be entitled to compensation for permanent disability.

Types of permanent disability?

The extent of your permanent disability has an effect on the amount of compensation you are entitled to receive. There are two basic categories of permanent disability benefits: total and partial, which we will discuss separately bellow.

What is total permanent disability?

We speak of total permanent disability when as a result of your injury and subsequent disability, you are not expected to be able to work for the rest of your life in whatever capacity. Due to the high threshold for proving total permanent disability, it is rare in workers’ compensation cases.

Nevertheless, the California Labor Code provides for certain permanent disabilities to be presumed as total (paragraph 4662, letter “a”). These are the following:

  • Loss of both eyes or the sight thereof;
  • Loss of both hands or the use thereof;
  • An injury resulting in a practically total paralysis;
  • Whether the employee is or will be able to obtain any employment whatsoever;
  • An injury to the brain resulting in permanent mental incapacity.

For all other cases not falling within those provided above, total permanent disability shall be determined on a case-by-case basis in accordance with the facts of each case, depending on their permanent disability rating (see below for clarification), which would need to be a 100% in order to be considered as total.

What is partial permanent disability?

Any permanent disability which is not total, meaning that it does not fall within the explicitly listed cases under paragraph 4662, letter “a” of the California Labor Code, or that it has a permanent disability rating of less than a 100%, is considered as a partial disability.

How does the rating process begin?

The process for rating permanent disability begins with medical reports. The physician who is treating you shall write a report which describes any permanent impairments that you have as a result of your injuries, which happens usually at the time the P&S report is written. This report details the normal loss of use of your injured body part, or the loss of normal psychological functioning.

In order to do that, physicians follow detailed guidelines in order to describe your impairments. If there is disagreement with respect to the content of the report, a qualified medical evaluator may be selected in order to provide another expert opinion on the situation in question. For more information on qualified medical evaluators (QME), please refer to the relevant article within our site or contact one of our Los Angeles Workers Comp Attorneys.

How do I receive my permanent disability rating?

After your doctor has completed their medical report, the findings of the report are translated into a permanent disability rating, which shows how much of an effect your disability has on the work you are able to do.

The rating process happen through the application of a complex formula which takes into account age, occupation, and physical and mental limitations. If you are unhappy with your permanent disability rating, you have the right to challenge it, as it plays a very important role in determining the amount of the compensation that you may be entitled to receive.

Can I get benefits if the permanent disability resulted from my injury aggravating another condition?

There is no easy answer to this question, because like many other issues relating to workers’ compensation, this depends on the specific facts of each case. Generally, having a pre-existing medical condition will not necessarily prevent you from getting benefits if that condition was aggravated by the work-related injury you sustained. However, it will be important when permanent disability benefits are being calculated, as the State of California requires that doctors apportion the disability between the old and the new injury/illness.

What amount of permanent disability payments can I receive and for how long?

For both total and partial permanent disability, the weekly amount of benefits shall amount to two-thirds of your average weekly wage. However, you should be aware that the minimum and maximum amounts differ depending on the date that you were injured. For example, for injuries sustained between 2014 and 2018, the minimum amount of benefits is $160 per week, and the maximum is $290 per week.

The difference between partial permanent disability benefits and total permanent disability benefits depends in how long you receive the payments. The former last only for a certain number of weeks, which are calculated according to the California Labor Code, paragraph 4658, meaning they are based on the date you were injured and your respective permanent disability rating.

Example: If an employee has a permanent disability rating of 50%, and has sustained an injury in 2017, that employee would be entitled to receive payments for a period of 400 weeks. If the rating was only 20%, then that period would only be 100 weeks.

Moreover, even if you do not qualify for total permanent disability benefits, if your permanent disability rating is 70% or more, then you may also be entitled to receive a life pension, which essentially represents small ongoing payments after the regular ones are paid out. The amount of your life pension depends on the date of injury, amount of your wages, and of the level of disability.

When do I begin receiving permanent disability benefits?

Generally, you begin receiving permanent disability benefits within 14 days (two weeks) after the payment of temporary disability benefits cease. You should receive payments from the relevant insurance company at least every two weeks.

What happens if my permanent disability benefit payments are late?

In some instances if the insurance company delays any payments for over two weeks, regardless of the reason, you may be entitled to an automatic additional 10% of the amount of the late payment. If there is no reasonable excuse for the delay, then you could receive up to 25% of the amount of each late payment, with a cap of $10,000, in accordance with paragraph 4650 of the California Labor Code.

Conclusions

As can be seen, there are various factors which need to be taken into consideration when an employee believes they have sustained a permanent disability. In order to make sure that you do not miss anything important when making your claim, and to ensure that your interests are protected, contact our Workers Comp Attorneys Los Angeles to get a consultation and advice regarding your injury, and to obtain the maximum benefits that you may be entitled to.

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