Permanent Disability Benefits Within California's Workers' Compensation System

Although many workers fully recover from their workplace injuries, some will unfortunately continue to have medical problems. If that is the case for you, you do not have to suffer your permanent disability in silence. 

Those who have suffered a work-related injury or illness before 2005 may qualify for Permanent Disability, or P.D.  benefits within California's Workers' Compensation system. To qualify, your injury or illness results in permanent symptoms, loss of function, work restrictions, or a decreased ability to compete in the labor market.

Read on to learn more about how Permanent Disability law is calculated and what that can mean for your case.

Permanent Disability Before 2005

Under the "old" system, weekly payments given to those who suffered permanent disability were based on a person's loss of ability to compete in the open labor market. 

The rulings were much stricter and would only be based on one section of The American Medical Association Guidelines, 5th Edition, otherwise known as the AMA Guides, instead of using the whole book as a basis.

How Does Permanent Disability Work Now?

Permanent Disability is evaluated and calculated in a new way now, a new system has been implemented in order to ensure every Workers’ Compensation case is treated equally and fairly. After 2005, the California Labor Code prescribed an updated criteria for which to judge Permanent Disability. Benefits for claims are based in part on a book entitled The American Medical Association Guidelines, 5th Edition (AMA Guides).  

The book’s purpose is to provide an "objective basis" for evaluating loss of overall bodily function. Disabilities caused by subjective symptoms (pain) without objective findings may no longer be compensated. This is to ensure equal opportunity for those who suffer from P.D.

The new guidelines may also apply to injuries before 2005, which could get you benefits previously unavailable to you. if a doctor did not declare an injured worker "permanent and stationary" prior to 2005, or if the employee has not returned to work after a period of Temporary Disability before 2005 they may be eligible for new or additional benefits.

What Role Does The Court Play In Your Case?

Permanent Disability benefits have also been significantly altered by reforms passed in 2004 and 2012. Knowledge of these changes can help you in your potential case. Court decisions, particularly the Almaraz/Guzman series of cases, have given injured workers an opportunity to be compensated more accurately by allowing a physician to use different charts and tables in the Guides in describing permanent disability.

What Were The Almaraz/Guzman Cases?

The Almaraz/Guzman series of cases refers to a set of pivotal California Workers' Compensation cases that addressed how to interpret and apply the AMA Guides to Permanent Disability cases. These cases established that evaluators could use any part of the AMA Guides to ensure a fair and accurate assessment of an employee's impairment, rather than strictly following the guidelines' specific chapters or methods. 

This flexibility aimed to achieve a more equitable determination of permanent disability benefits.

How Much Will My P.D Be Worth?

The final P.D. rating, which looks like a percentage between 1 percent and 99 percent, establishes the amount of your award and the length of time your benefits will be paid. 

Your final P.D. rating will tell you the amount of compensation you are entitled to receive and how severe your case is. A major benefit of the updated P.D system is that eligible employees may receive benefits even if they choose to return to work. In addition, those same benefits can often be paid tax free. All this to say that with the new P.D system, you will be ensured that you are provided financial support to assist with any needs that may arise with your case.

What Can Affect My P.D. Rating?

There are many elements that factor into your final P.D score.Some of these factors are based on the injury or illness itself, such as our medical condition, as described in a permanent and stationary report or in a medical-legal report. Others have to do with the job in which the case took place, such as Your occupation and How much your disability is caused by your job. Finally, some criteria just come down to timing, such as your date of injury and your age when injured.

Who Can Help?

With all the changes in Permanent Disability Law, it might start to seem confusing. 

Understanding the latest regulations and requirements can be overwhelming. There’s no need for you to worry if this all seems complicated at first. A capable attorney can help you navigate through these changes. They will ensure that you receive the most accurate P.D. award possible for your case.

Full Disclosure Is Paramount

In order to get the best possible P.D. award for your case, it is crucial that you be as transparent as possible with both your attorney and the court. Complete honesty ensures that your attorney can effectively advocate for you and get you the best possible outcome. Employees must disclose previous disabilities upon request. 

Additionally, it is important to note that your employer is only liable for the permanent disability that was caused by your workplace injury. The distinction is vital for determining the appropriate amount of compensation you are owed in your case.

What Do I Do If I Have Been Injured Before?

Any previous Permanent Disability that has been awarded is now assumed to be present when a new injury happens. Successive awards may never exceed 100 percent for multiple injuries to any one region of the body. This issue is known as apportionment, and the law is constantly evolving on this issue. If your award is being reduced because of a pre-existing condition or prior award, you should consult an attorney before agreeing to the settlement, to ensure you receive the most accurate outcome.