- 29-Apr-2025
- Personal Injury Law
In workers' compensation cases, the percentage of total disability plays a crucial role in determining the compensation benefits that an injured worker is entitled to receive. This percentage is determined based on medical assessments and evaluations of the worker’s ability to perform daily tasks and work-related activities. The disability percentage reflects the severity of the injury or illness and the worker’s long-term ability to earn a living.
The disability percentage is primarily determined by a medical evaluation conducted by a healthcare professional, typically a doctor or a qualified medical examiner. This evaluation assesses the severity of the injury, the extent of functional impairment, and the worker’s recovery potential.
Example: A worker who sustains a spinal cord injury might undergo a thorough medical evaluation to determine the level of impairment and the worker’s ability to move, walk, or perform other physical tasks. This assessment helps determine the disability percentage.
An impairment rating is a key factor in determining the total disability percentage. This rating is based on medical guidelines such as the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, which provides a standardized method for quantifying the degree of permanent impairment caused by an injury or illness.
The impairment rating is then translated into a percentage, which represents the worker’s total loss of function.
Example: An arm amputation might result in an impairment rating of 70% total loss of function, meaning the worker’s disability percentage is 70%.
A functional capacity evaluation (FCE) assesses how the worker's injury impacts their ability to perform physical tasks, including lifting, walking, sitting, standing, and other work-related activities. This helps in determining how much of the worker’s capacity to work is impaired by the injury.
Example: A worker who has lost mobility in one leg may undergo an FCE to determine the extent to which their walking and standing abilities are impaired, which contributes to the overall disability percentage.
The loss of earning capacity refers to the worker’s ability to return to work and earn a comparable income. If the worker is unable to return to their former job or can only work in a limited capacity, the disability percentage may be higher. Factors like age, education, job skills, and prior income may influence this assessment.
Example: A construction worker who sustains a permanent injury preventing them from returning to manual labor may experience a higher disability percentage due to the inability to return to their prior earning level.
Total disability refers to a condition where the worker is completely unable to perform any type of work due to the injury. The disability percentage for total disability can range from 0% (no disability) to 100% (total disability). The worker’s ability to return to their occupation, their likelihood of finding alternative employment, and their ability to carry out daily activities all play a role in determining the percentage.
Example: A worker who loses the use of both legs in an accident may be classified as 100% disabled, which indicates total disability.
Different jurisdictions may have specific formulas or guidelines for calculating disability percentages. Some areas use state-specific disability rating systems, which may vary from medical impairment ratings. For example, in some places, compensation is based not only on the medical impairment but also on how the injury impacts the worker’s ability to earn wages.
Example: In one state, a worker with an amputation might be given a specific disability percentage based on a schedule, whereas another state might base it on the overall impairment and lost earning capacity.
Some workers’ compensation systems use a scheduled loss system, where specific body parts (e.g., fingers, arms, eyes) are assigned a fixed disability percentage. For example, the loss of a thumb might be rated at 30%, while the loss of a leg could be rated at 50%.
Example: A worker who loses an index finger in an accident might receive a fixed disability rating according to the workers’ compensation schedule for finger losses.
For injuries that affect the body as a whole (e.g., spinal injuries, brain injuries), the total disability percentage may be based on the overall impairment to the entire body’s function. This approach considers the injury’s impact on the worker’s ability to perform daily tasks and maintain employment in general, rather than focusing on specific body parts.
Example: A worker with a brain injury that causes cognitive and motor impairments might be given a disability percentage that reflects the overall loss of function, rather than just one part of the body.
In some cases, a vocational assessment is conducted to determine how the worker’s injury impacts their ability to find suitable employment. This assessment includes an analysis of the worker’s skills, education, and labor market conditions. If the injury significantly impacts the worker’s ability to find new employment, the disability percentage may be increased.
Example: A worker with a severe back injury who cannot return to physical labor but has limited office skills may receive a higher disability rating due to limited job options.
A factory worker suffers a severe hand injury that leads to the permanent loss of hand function.
A medical examiner assigns an impairment rating based on the AMA Guides, rating the loss of the hand as 70% impairment.
A vocational assessment is conducted and shows that the worker can no longer return to their previous job and may only be able to find part-time desk work.
Based on these evaluations, the worker may be assigned a total disability percentage of 70% to 80%, impacting the compensation they will receive.
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