At DuRard, McKenna & Borg, we represent injured workers in San Mateo and the San Francisco Bay Area in workers' compensation matters. We assist workers in settling workers' compensation disputes and recovering benefits, including permanent disability benefits.
Eligibility for Permanent Disability Benefits
You will be eligible to receive permanent disability benefits if your workplace injury or illness has left you with permanent limitations on your ability to compete in the open labor market or unable to work at all. The amount of benefits and the duration of time for which you are entitled to receive benefits will vary depending upon the extent of your permanent limitations.
Factors which will be considered in determining the amount of your disability benefits include:
- The part of your body that is injured;
- The extent of your injuries;
- The extent of your restrictions; and
- Your age and occupation at the time of the injury.
These factors are taken into consideration by California's standard permanent disability rating formula, which is used to determine the percentage of your labor market disability, i.e., the effect of your disability on your ability to earn wages. These disability ratings are tied to specific dollar amounts which you will be paid for a limited duration. If the rating is between 70% and 100%, you will also be entitled to an additional, but small, life-time pension.
Disability Rating Process
The disability rating process begins when your doctor declares that your condition is "permanent and stationary" (P&S) or that you have reached "maximum medical improvement" (MMI). At the status of P&S or MMI, you have had all the available treatment which is likely to improve your condition and are not getting any better. At this point, your condition is considered to be permanent and temporary disability benefits will be terminated.
If your treating doctor has taken you off of work or restricted your work duties during the period of your temporary disability, he or she must determine whether you are able to return to your usual job or whether you have permanent work restrictions that prevent you from performing your job as you did before your injury. Your doctor must also determine the extent to which your injuries were caused by the work-related accident or conditions or other non-work related conditions, such as a prior injury.
Your doctor will notify your employer or employer's workers' compensation insurance carrier (sometimes called the claims administrator) of your permanent condition and restrictions, and then your case must be reviewed by a medical doctor who will issue a permanent disability rating. Depending upon whether or not you are represented by an attorney, your case will be referred to the Disability Evaluation Unit (DEU) of the Division of Workers' Compensation, a Qualified Medical Examiner (QME) or Agreed Medical Examiner (AME). Either the DEU, QME, or AME will review your case, including all medical records, and determine your disability rating based the factors discussed above. You have a right to receive a copy of the disability rating report and challenge its findings if you disagree with them.
Benefits of Legal Representation in Obtaining Permanent Disability Benefits
If you have reached the permanent disability ratings stage of your workers' compensation case, and you are not yet represented by an attorney, contact one right away. There are short time limitations for taking the required actions at this phase, including limitations affecting whether you have a say in which doctor examines your case.
Not all examiners are equal; some are more familiar with the workers' compensation process and relevant disability rating factors, and some are more pro-injured employee than others. An experienced workers' compensation lawyer can help you chose a private examiner that he or she believes will provide a fair and adequate report. Additionally, an experienced workers' compensation lawyer will also be in the best position to help you challenge the disability rating report if you disagree with it.
Contact Experienced Workers' Compensation Lawyers
The permanent disability ratings stage of workers' compensation case is critical. At DuRard, McKenna & Borg, we can help ensure that you receive a fair rating that adequately takes your permanent disability and diminished earning capacity into account. Our lawyers speak Spanish, Hindi, and Arabic, allowing us to serve the diverse community of the San Francisco Bay Area. We offer free initial consultations, as well as take cases on a contingency fee basis, meaning you pay no legal fees unless we help you recover. Call us today at (650) 425-3278.