Understanding Impairment Ratings in Alabama Workers Compensation Cases

Understanding Impairment Ratings in Alabama Workers Compensation Cases

One of the most common questions injured workers ask after reaching Maximum Medical Improvement (MMI) is: “The doctor gave me an impairment rating. What does that mean?”

Unfortunately, there is a great deal of confusion surrounding impairment ratings and how they affect workers’ compensation benefits in Alabama.  Many injured workers assume that the impairment rating assigned by their physician automatically determines the value of their workers’ compensation claim. In reality, the law is much more complicated.

What Is an Impairment Rating?

After an injured worker reaches Maximum Medical Improvement (MMI), the treating physician will often evaluate whether the worker has sustained a permanent physical impairment as a result of the workplace injury.  If the physician believes a permanent impairment exists, they may assign an impairment rating.

Generally speaking, the impairment rating is intended to represent the degree of permanent physical loss resulting from the injury.

For example, a physician may assign:

• A 5% impairment;
• A 10% impairment;
• A 20% impairment; or
• Some other percentage.

The higher the rating, the greater the physician believes the permanent physical impairment to be.

Where Do Impairment Ratings Come From?

Many physicians use the American Medical Association’s Guides to the Evaluation of Permanent Impairment when assigning impairment ratings; however, this often creates confusion because the AMA Guides themselves specifically state that they were not designed to determine disability or compensation under workers’ compensation laws.

The Guides attempt to measure medical impairment.

Workers’ compensation law often focuses on something different: How the injury affects the worker’s ability to perform job duties.  Those are not always the same thing.

Alabama Law Does Not Define “Permanent Physical Impairment”

Interestingly, Alabama’s Workers’ Compensation Act provides compensation for permanent physical impairment, but the statute does not provide a detailed definition of what constitutes a permanent physical impairment.  As a result, physicians, attorneys, and courts often rely upon medical evidence, functional limitations, vocational evidence, and other factors when evaluating the effects of an injury.

Is the Court Bound by the Doctor’s Impairment Rating?

No.  This is one of the most important things injured workers should understand.  While an impairment rating is certainly evidence that may be considered by the court, an Alabama trial judge is not automatically bound by the physician’s rating.

The court may consider:

• Medical records;
• Physician testimony;
• Functional limitations;
• The worker’s own testimony;
• Vocational evidence; and
• Other evidence presented during the case.

In some cases, a court may determine that the practical effects of an injury are greater than the physician’s assigned rating might suggest.

Scheduled Injuries Versus Non-Scheduled Injuries

To understand why impairment ratings matter differently in different cases, it is important to understand the distinction between scheduled and non-scheduled injuries.

Scheduled Injuries

Alabama’s Workers’ Compensation Act contains a schedule assigning a specific number of weeks of compensation for the loss or impairment of certain body parts.

Examples include injuries involving:

• Fingers
• Hands
• Arms
• Toes
• Feet
• Legs
• Eyes
• Hearing

These are commonly referred to as scheduled injuries as the Alabama Code specifies how many weeks of benefits an injured worker may typically receive for their permanent impairment.

When an injury remains confined to a scheduled member and does not affect the efficient functioning of the rest of the body, compensation is generally limited to the benefits provided in the schedule; vocational disability evidence is generally not available in cases involving purely scheduled injuries.

In other words, the focus is typically on the impairment to the body part itself rather than the worker’s overall ability to earn wages.

Non-Scheduled Injuries

Other injuries are treated differently.  Examples often include injuries involving:

• The back
• Neck
• Spine
• Shoulders
• Hips

Likewise, injuries that affect the body as a whole (such as chronic pain) may be considered non-scheduled injuries.

For these cases, the court may consider not only the medical impairment itself, but also the injury’s effect on the worker’s earning capacity.  This is where vocational evidence frequently becomes important.

Why Vocational Disability Matters

A worker’s impairment rating and vocational disability are not the same thing.

Consider two workers who receive the same 10% impairment rating.  One worker may return to the same job, earning the same wages, while the other worker may be unable to return to their previous occupation and may have little transferable job skill.

Although the impairment ratings are identical, the vocational impact of the injury may be dramatically different.

For non-scheduled injuries, Alabama courts may consider factors such as:

• Age;
• Education;
• Work history;
• Transferable skills;
• Physical restrictions;
• Pain;
• Medication side effects; and
• Ability to obtain reasonably gainful employment.

Can a Low Impairment Rating Still Result in Significant Disability Benefits?

Absolutely.

One of the most common misconceptions in workers’ compensation law is that a low impairment rating automatically means a low-value claim-that is simply not true.

In some cases, workers with relatively modest impairment ratings have been found permanently and totally disabled because of the practical effect the injury had on their ability to work.  For example-I have had multiple hernias, and my surgeon has stated I cannot do more than light duty work.  For a construction worker-this restriction would effectively mean they cannot return to their profession, while I am able to perform the majority of my job duties.

Conversely, a worker may receive a relatively high impairment rating but continue to earn the same wages and experience little vocational loss.

The Real Question

While impairment ratings are important, the real question in many Alabama workers’ compensation cases is not “What percentage rating did the doctor assign?” The more important question is often “How has this injury affected the worker’s ability to earn a living?”

For many injured workers, that issue ultimately becomes far more important than the impairment rating itself.

If you have reached Maximum Medical Improvement and have questions about impairment ratings, permanent disability benefits, vocational disability, or any other aspect of an Alabama workers’ compensation claim, it may be helpful to speak with an attorney experienced in representing injured workers.

At Powell and Denny, we have spent decades helping injured workers throughout Alabama understand and protect their rights under the Workers’ Compensation Act, so if you have suffered a job injury and you have questions about your rights and benefits under Alabama’s workers compensation laws -don’t hesitate to contact and speak with one of the experienced Alabama Workers Compensation and Social Security Disability attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

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