A lot of people have heard of an injured worker getting a “rating,” sometimes referred to as a “disability rating,” for their work-related injury. However, you may not know what this rating is exactly, how you get it, or how much money the insurance company has to pay you because of it. This post gives a brief overview of ratings in the North Carolina Workers’ Compensation System, and shows you how to calculate the amount of money that you are entitled to because of your rating.
The typical course of a work related injury might look like the following. You are injured at work, say you fall and hurt your knee, and you report this to your employer. Your employer sends you to a Doctor, who thinks you might have some real damage in your knee, and so you see an Orthopedic Specialist. The Orthopedic Specialist writes you out of work while you are undergoing treatment, and so the insurance company starts paying you weekly benefits in the amount of two thirds of your average weekly wage. If they don’t do this voluntarily, you might hire an attorney to represent you to fight the insurance company to get them to pay you your weekly benefits.
In the meantime, the Doctor says that you have a torn ligament, and need surgery. You have this surgery, and your recovery from it goes pretty well. After the surgery, you undergo some physical therapy, and maybe you work light duty during this time. Eventually, your knee is pretty much healed, but it is never going to be in the great shape it was in before you hurt it. The Doctor tells you that you may have some problems with that knee down the line (for example you might get arthritis in that knee), but there is nothing more she can do for you. She then might tell you that she is giving you a rating of 10% and releasing you back to full duty work. You are able to return to the job you were doing before the injury, but what is this rating all about?
A “rating” is the term used for the degree of “Permanent Partial Disability”, or PPD, that your Doctor has assigned you for the body part you injured at work. Under the NC Workers’ Comp. Act, once you finish healing from your injury, you are entitled to a certain amount of money in PPD based on the rating that your Doctor has given you. The idea is that your employer or (more commonly) your employer’s insurance company should have to pay you for the permanent damage to your body that you have suffered as a result of your work injury. The statute is 97-31, which gives a “schedule” for the compensation you are due, depending on your body part and the amount of money you made before you were injured. It might sound a little odd, but the statute actually gives a formula that will give you a certain amount of money for the loss of any specific body part you can think of. Lose a finger? The statute will tell you how much that finger is worth.
The statute itself gives the amount of compensation you would be due if you completely lost that body part. For example, if you lost your thumb, you are entitled to two thirds of your average weekly wages for 75 weeks, paid in one lump sum. So, for example, say you had to have your thumb amputated because of a work-related injury. Say you made $600.00 a week before you were injured. Under the statute, the loss of a thumb is worth two thirds of your average weekly wage during seventy five weeks. So you multiply two thirds of your average weekly wage (two thirds of $600.00 is about $400.00), times 75 weeks, which means you are owed about $30,000.00 in one lump sum.
A rating is a percentage of this total loss. So, for example, a 10% rating to your thumb means you have permanently lost 10% of the use of your thumb. To figure out how much this rating is worth, you multiply your rating by the number of weeks that the statute gives for total loss. To use the example above, the total loss of your thumb is worth 75 weeks. A 10% rating to your thumb is worth 10% of 75 weeks, which is 7.5 weeks. Multiply 7.5 weeks times two thirds of your average weekly wage (which we said was about $400.00), and voila, your 10% rating is worth $3,000.00.
Keep in mind that ratings are worth very different amounts depending on the body part you injured. A 10% rating to your back, for example, is worth two thirds of your average weekly wage for 30 weeks, which is obviously a lot more than the 7.5 weeks you got for that 10% to your thumb. The statute includes most body parts that you might injure, and provides money that you might be due if your body part isn’t included.
The only way to get a rating is to get a Doctor to assign you one. If your Doctor is getting ready to release you, it is perfectly OK to ask him or her if you will be getting a rating. However, Doctors have guidelines they must follow when assigning ratings based on the specific facts of your injury, so they don’t just “make them up.” If you or your attorney feels like your rating was too low, or you or your attorney thinks you didn’t get one when you should have, the Workers’ Comp. Act gives you the right to have the insurance company pay for a second opinion on the rating with another Doctor. Keep in mind, however, that the second opinion Doctor could give you a lower rating than your treating Doctor did.
I hope this post has given you some useful information. Keep in mind that the foregoing analysis is based on a very simple case, where you have an injury, are not fired by your employer, and are able to go back to your old job making the same amount of money after you are finished healing from your injury. If you have multiple injuries, you are fired by your employer after your injury, or you are unable to go back to your old job because of your injury, you may be entitled to a lot more money than just your rating. If you are unsure if you are entitled to more than just your rating, you can call a workers’ compensation attorney for advice. Keep in mind that most workers’ comp. attorneys will give you a free consultation.