Disability ratings are among the most complex aspects of work injury claims in Louisiana. At Wanko Law, we believe anyone injured on the job deserves immediate access to experienced legal help from the outset of their claim.
Louisiana workers’ compensation law provides medical care, lost wages, and other benefits to most employees who are injured on the job, regardless of fault. However, these benefits are paid by some of the nation’s largest insurance companies. From the start of your claim, an insurer will assign your claim to a team of adjusters, investigators, lawyers and medical experts, with a focus on limiting the cost of your claim.
Unfortunately, injured workers too often fail to understand the complexity of the system. In other cases, they may not believe an initial injury is serious until complications arise or an insurer attempts to blame injury or the need for medical care on a pre-existing condition, or otherwise denies a claim.
Significant disagreements often arise when a return-to-work order is issued or when an employee disputes a disability rating. In cases involving severe injuries, such as spinal injuries, a more detailed evaluation is typically required to assess the full extent of the damage. Early consultation with an experienced workers’ compensation lawyer in New Orleans, Covington, or Raceland can help ensure that you receive all the benefits to which you are entitled throughout each stage of the process, especially when dealing with complex injury claims.
In Louisiana, a workers’ compensation disability rating, or impairment rating, helps determine to what extent an employee has been injured. Initially, most employees will receive medical care and Temporary Total Disability (TTD) benefits.
An employee who suffers a covered injury is entitled to immediate medical care. He or she is eligible for wage benefits after 7 days. No compensation shall be paid for the first week after the injury occurs unless the disability from the injury continues for two weeks or longer after the date of the accident.
For longer-term consequences of a work injury, a workers’ compensation insurer will generally seek a medical evaluation to determine an impairment rating as a first step to making a settlement offer. Impairments generally affect an employee’s ability to perform his or her job, and can have a major impact on a claim.
Impairment ratings in Louisiana are based on the 6th American Medical Association Guides to the Evaluation of Permanent Impairment. Impairment, under Louisiana workers’ compensation law, means abnormality or loss following maximum rehabilitation. As such, an impairment rating is generally determined following a determination of maximum medical improvement (MMI). Each of these determinations can have significant long-term impacts on your ability to collect benefits and are always best handled with the help of an experienced workers’ compensation law firm.
An impairment rating is provided as a percentage - from 0 to 100. Impairment ratings may be different for each affected body part, and combined to provide a “whole person” impairment rating. While legal framework is provided, medical opinion and subjective determinations play a significant role and disagreements among providers, including medical professionals who work for the workers’ compensation insurance company, are commonplace.
Impairment ratings are usually determined during a Functional Capacity Evaluation (FCE). This rating is often used by the insurance company to determine monetary awards. However, under Louisiana law, an impairment rating is not used to determine Supplemental Earnings Benefits, Temporary Total Disability benefits or Permanent Total Disability benefits. Rather, this impairment rating percentage is used to determine a monetary award under LA R.S. 23:1221 for Permanent Partial Disability (PPD) benefits, which concerns cases of amputation or loss of use of parts of an injured employee’s body.
For these reasons, it is somewhat rare that an impairment rating will be required for a Louisiana workers’ compensation claim. However, the fact that workers’ compensation insurance companies frequently insist injured workers undergo such examinations, and then use these ratings in settlement negotiations, leaves injured workers exposed and confused. This is another example of why consulting with an experienced Louisiana workers’ compensation law firm at the outset of your case is often vital to protecting your rights and the financial well-being of you and your family.
If you have been injured, call day or night for a free and confidential consultation to discuss your rights. Call 985-202-9907.
Related: Can You Work While Receiving Permanent Disability or Social Security Benefits in Louisiana?
Social Security Administration - Disability Evaluation Under Social Security: Comprehensive guide for health professionals on the disability programs managed by the Social Security Administration. It details how disability claims are processed, emphasizing the role of the Listing of Impairments, which helps determine eligibility for disability benefits based on specific criteria. This resource is crucial for understanding how impairments are assessed legally and can aid in aligning medical evidence with SSA requirements for disability claims. This information can be particularly useful in impairment ratings cases by providing a framework for what constitutes a disability under federal guidelines.
Occupational Safety and Health Administration (OSHA) - Workers' Rights and Protection: Outlines workers' rights under federal law to a safe workplace, free from recognized hazards. It details rights to receive safety training in understandable languages, use safe equipment, refuse unsafe work, and receive necessary safety gear. Workers can request OSHA inspections and report injuries without fear of retaliation. The page also provides guidance on filing safety complaints and whistleblower complaints if rights are violated. This information can assist workers in understanding and advocating for their safety rights, which could be relevant in cases involving workplace injuries and impairment ratings.
American Medical Association - Guides to the Evaluation of Permanent Impairment: Standardized system to evaluate and report on the extent of an individual's injury and how it impacts their daily activities. This system is critical for medical professionals, insurers, and legal entities to determine fair compensation for permanent impairments. The AMA offers updated guides through a digital platform, ensuring that the information reflects the latest medical advances and maintains high standards for assessment accuracy.This resource is beneficial for an impairment ratings case as it provides a reliable framework for evaluating and documenting permanent impairments, ensuring that all parties involved have a clear and consistent understanding of the assessment.
