Workers' comp disability ratings

Processing disability payments can be complicated. While workers’ comp payments may cover immediate medical bills and missed wages, disability payments can last years. These payments may be temporary or permanent and are dependent on what is called a workers’ comp disability rating. This rating is a percentage, assigned to an injured employee by a medical examiner, that determines how much – if at all – the employee is able to return to full work at their previous job.

Temporary and permanent disability

Under Oklahoma law, there are four types of workers compensation disability for which an employee can qualify.

  • Temporary partial disability. This type of disability applies to workers who can return to work in some capacity, but may not be able to do their original job right away. Because this designation is temporary, the expectation is that the employee will eventually heal and be able to return to their original job. An example of this might be an office worker who sustained a broken hand injury while at the workplace; they may not be able to type properly for a few weeks, but the hand should heal, and they should eventually be able to go back to their original position.
  • Temporary total disability. This type of disability applies to workers who cannot do their original jobs at all for a period of time. In Oklahoma, workers can receive compensation for 70% of their average weekly wage, not to exceed 100% of the state’s average weekly wage. As with temporary partial disability, the expectation is that, after recovery, the worker should be able to return to their original job. Temporary total disability payments typically do not exceed two years.
  • Permanent partial disability. This type of disability applies to workers who have sustained work-related injuries or illnesses that prevent them from returning to their original jobs. However, they may return to working in a different capacity, or with altered job duties. For example, a longshoreman might incur a back injury at work that, even after surgery, has permanently affected his ability to lift heavy objects. This employee might be able to work another job at the company, as long as he does not need to lift heavy objects. In this case, this worker would receive permanent work injury compensation for a certain amount of time, depending on the injury/illness.
  • Permanent total disability. This type of disability applies to workers who cannot return to any form of employment due to work-related injuries. (This designation is also dependent on the worker’s qualifications and experience; for example, a welder who lost both legs at work is not expected to obtain a computer programming job, because that worker does not have the education or experience in that area.) Employees can receive permanent total disability payments until they are old enough to qualify for Social Security retirement benefits. Depending on when the injury occurred, this could mean many years of workers’ comp disability compensation. Employees who receive permanent total disability payments are also not permitted to hold a job elsewhere; if they do, their benefits could be suspended.

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Calculating disability ratings

Workers’ comp disability ratings are typically assigned to workers who have sustained permanent partial disabilities. After any injuries have healed to the extent that is possible, also known as the “maximum medical improvement” (MMI) level, a medical examiner can assess the workers and assign a disability rating. This rating is expressed as a percentage of impairment as it relates to the worker’s ability to do their job. A rating of 100% indicates a complete inability to do the job, and 0% indicates no disability at all.

Workers’ comp disability ratings are unique because they apply specifically to the job that the worker was doing before the accident or illness. For example, if a warehouse worker loses a pinky finger, they will not necessarily lose the ability to do their job. However, if a professional violin player loses a pinky finger, their ability to do their job is greatly affected.

In some states, like Oklahoma, disability ratings are assigned to specific body parts. In other words, a 100% disability rating is only relevant to the part of the body that is injured or impaired; it does not mean that the worker is entirely unable to work.

Let’s look at some examples from the Oklahoma Administrative Workers’ Compensation Act to see what a 100% disability rating means for different body parts.

  • Loss of/injury to arm or leg: 275 weeks
  • Loss of/injury to hand or foot: 220 weeks
  • Loss of/injury to thumb: 60 weeks

Now let’s look at what a 50% disability rating for these same body parts would look like:

  • Loss of/injury to arm or leg: 137.5 weeks
  • Loss of/injury to hand or foot: 110 weeks
  • Loss of/injury to thumb: 33 weeks

These examples illustrate that the disability rating drastically changes how much time the worker can receive workers’ compensation disability payments.

Workers’ comp impairment ratings

The term “impairment” is often used interchangeably with “disability,” but in terms of insurance and payouts, it is not a synonym. A workers’ comp disability rating refers to a worker’s ability to do their job; an impairment rating is based on how much that worker, as a whole, is generally impaired, regardless of what job they are doing.

Different states have different ways of calculating workers’ comp benefits. Some states, like Oklahoma, use disability ratings by body part to calculate permanent partial disability payments; other states use an impairment rating payout system, which bases disability payouts on “whole body impairment,” or that person’s ability to do any kind of work in the future. Sometimes states will use impairment ratings to calculate payments for “unscheduled losses,” or injuries and illnesses that do not fall neatly within a body part rate chart. This may include occupation-specific illnesses (like coal workers’ pneumoconiosis) and internal organ damage.

Why CompSource Mutual

Understanding workers’ compensation and its relationship to disability compensation can be challenging. CompSource Mutual is here to help business owners navigate this system and support their employees during times of medical distress. Our claims team is always ready to answer questions and provide assistance as needed.

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A disability rating is a doctor’s judgment on the severity of an injury. Workers’ comp disability ratings are given as percentages. For example, a doctor may assign a 20% disability rating to an injured foot, meaning that the patient has 80% functionality.

A permanent impairment is defined as an impairment that has reached maximum medical improvement (MMI) and is unlikely to change substantially in the next year with or without medical treatment. Each state workers’ compensation system has its own definition of impairment.

This depends on the level and type of injury, illness, or disability. A worker with a temporary disability may only receive payments for a short period of time, while a worker with a permanent total disability may receive payments for the rest of their life until Social Security retirement payments begin.

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PAT SMITH
OKLAHOMA CITY, OK

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