Some workplace accidents cause injuries that workers will eventually recover from, if they receive proper medical treatment and follow the doctor’s instructions. For example, if you broke your arm from a fall, it may heal and allow you to return to full health.
However, if you broke your arm in multiple places and have stress fractures, it may never fully heal. This could seriously impair your ability to use the arm the way you did before the injury. This type of injury might qualify for permanent disability benefits.
Other examples of injuries that may qualify for permanent disability benefits include:
If you developed a permanent disability because of a workplace injury, the permanent disability claims lawyers may be able to help you recover workers’ compensation benefits.
As your injury heals and your health improves, your doctor will try to determine if the injury has stabilized and your condition is not likely to improve any more. This is also known as the point of maximum medical improvement (MMI). Your doctor might say the injury has become permanent and stationary (P&S).
Once you reach this point, the doctor will evaluate you to determine if you are permanently disabled – this means that even though your condition has stopped improving, you still have limitations from the injury.
If the doctor determines you have a permanent disability, he or she will send a P&S report to the claims administrator stating that you have a permanent disability. The doctor will also note the cause of your permanent disability, whether it is from a workplace injury or a previous injury or other medical condition.
The P&S report will detail the following aspects of your medical condition:
The P&S report will affect the amount of benefits you receive and whether you receive any benefits at all. Make sure to ask for a copy by submitting a written request for these and all other medical reports related to your disability. Carefully review the P&S report to see if you disagree with anything in it.
If you disagree with the P&S report, you can request an exam from a qualified medical examiner (QME). A QME is a physician certified by the Division of Workers’ Compensation (DWC) who is licensed to practice in California. The DWC certifies different types of QMEs, including medical doctors, psychologists, optometrists and doctors of osteopathy.
Mail a Request For Qualified Medical Evaluator Panel to your claims administrator, along with a Proof of Service form, and the administrator can send it to the DWC Medical Unit. The DWC Medical Unit will send a list of three QMEs and send it to you within 20 working days of receiving your request. You have 10 days from the date the list is mailed to select a doctor, make an appointment and inform the insurance company. If you do not do this before the 10 days pass, the insurance company can do it for you.
If the insurance company disagrees with the P&S report, it can also request that you see a QME for an examination. The insurance company will send you a form for requesting a QME. You must submit the form within 10 days of receiving it, otherwise the insurance company will select the doctor you see.
One of the benefits of having an attorney at this stage is that he or she can work with the claims administrator to find a doctor to examine you. This doctor is known as an Agreed Medical Examiner. A Fresno permanent disability claims attorney will be focused on finding the right doctor to examine you to maximize your benefits.
After you have been examined, a report will be written about your disability. The report will include an impairment number that will be placed in a formula to calculate your percentage of disability. The formula also includes your occupation, age and future earning capacity. Any portion of your disability caused by something besides a work injury is taken out of the equation.
The percentage of disability is equal to a specific dollar amount of benefits, depending on your average weekly wages and the date of your injury.
An experienced permanent disability claims lawyer in Bakersfield can explain this process in more detail and give you a better idea of the value of your permanent disability benefit payments.
You will start receiving permanent disability benefits once temporary disability benefits end and your doctor says you have permanent limitations from your injury.
Your claims administrator is required to begin paying you permanent disability benefits within 14 days of your temporary disability benefits ending. If you were not receiving temporary disability, you should receive your first check within 14 days of the claims administrator learning you have a permanent disability.
The administrator will decide which day to pay you and you will receive a check every two weeks until a reasonable estimate of your disability amount has been paid. If you are totally disabled, you will be eligible to receive checks for the rest of your life.
If your current employer offers to pay you 85 percent of the wages and benefits you received before you became disabled, you will not receive permanent disability until a workers’ compensation judge approves a settlement or makes a decision on what you will receive. The same thing applies if you are working at a job that pays 100 percent of the wages and benefits you were paid at the time of the injury.
The permanent disability claims attorneys at our firm can explain these laws and regulations to you in a free consultation. Our goal is to obtain all the benefits you deserve so you are compensated for wages you can no longer earn because of your disability.
You may think your disability rating is lower than it should be, which means you are receiving less benefits than you feel you deserve. If this happens, you can contact the DWC to ask it to review the rating. The DWC can review the rating to determine if mistakes were made in the process, including mistakes during your medical evaluation.
You must submit a Request for Reconsideration of Summary Rating by the Administrative Director within 30 days of receiving the rating. There are only four reasons you can submit this form:
There is also a section for you to explain the reasons for your request. You can attach additional sheets if necessary.
Another way to dispute your disability rating is to have your attorney present your case to a workers’ compensation administrative law judge.
Our permanent disability claims lawyers in Fresno can help you dispute your disability rating. Our goal is to pursue all the benefits you deserve for your workplace injury or illness.
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Bakersfield, CA 93309
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Fresno, CA 93704