Disability Ratings

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.

In many cases, significant disagreements occur when a return-to-work order is issued or an employee disagrees with a disability rating. Early consultation with an experienced workers’ compensation lawyer in New Orleans, Covington or Raceland can help ensure you receive all of the benefits to which you are entitled at each stage of the process.

Louisiana Workers’ Compensation - Disability Ratings

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.

• Medical benefits: An employee has a right to choose one doctor in each specialty field for treatment of an on-the-job injury. Non-emergency medical services over $750 are subject to pre-approaval and authorization. Such expenses may be challenged by the workers’ compensation insurer and are subject to legal review.
• Temporary Total Disability (TTD): Two-thirds of an employee’s average wage, subject to statutory minimums and maximums.

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 985-893-6530.