Impairment ratings can be a real head-scratcher. Let's jump right in and make sense of it all.
Impairment Ratings are basically a way to measure how much a work-related injury has affected you. There are a few different types to know about: temporary disability, permanent disability, and partial disability.
When it comes to New York workers’ compensation, “impairment rating” usually refers to a permanent partial disability. This rating shows how much of a lasting impact your injury has after you’ve reached a point where further recovery isn’t expected. It’s different from a temporary disability rating, which only applies while you’re still healing, and it’s not the same as ratings for permanent total disability or injuries to specific body parts, like a hand or foot.
When it comes to permanent disabilities in workers' comp, there are two main types you should know about: permanent partial disability (PPD) and schedule loss of use (SLU).
Permanent Partial Disability (PPD)
This applies to injuries that affect your head, neck, back, or any psychological or systemic conditions. These are more serious injuries that can impact multiple areas of your body. For example, if you have a major back injury that limits your ability to work, or a work-related psychological condition, you’d fall under PPD.
Schedule Loss of Use (SLU)
SLU, on the other hand, covers injuries to specific body parts like hands, feet, arms, and legs. Each body part has a set value in terms of weeks of compensation—so losing the use of a thumb, for instance, is worth more than losing a pinky. If you’ve got multiple injuries affecting different extremities, SLU could apply to all of them.
In some cases, if an extremity injury is severe enough, it might get classified as a permanent partial disability instead. This usually happens when an arm or leg injury is so bad that it affects your ability to work the same way a back or neck injury would. But this kind of reclassification is pretty rare.
The key idea with Impairment Ratings is Loss of Wage Earning Capacity (ELWAC). This isn’t just about your physical injury—it also takes into account your work history, skills, and education to figure out your overall disability level and how much compensation you qualify for.
Here’s a real-world example: Imagine two workers with the exact same back injury.
Worker A has a college degree, speaks multiple languages, and has specialized training.
Worker B doesn’t have a formal education and has limited job skills.
Even if both are given a 50% permanent disability rating, their ELWAC could be very different. Worker A, with more skills and education, has better chances of finding another job, so their ELWAC might be lower. Worker B, who has fewer job opportunities, could end up with a higher ELWAC, meaning they’re considered more disabled in terms of future earning potential.
This rating matters because it’s not just about your injury—it’s about how your injury affects your ability to make a living. If you have a permanent partial disability, your impairment rating is a huge factor in determining your compensation. That’s why it’s so important to understand and make sure your rating is accurate.
Your job background plays a big role in your impairment rating.
If you have a wide range of skills, higher education, or specialized training, you might have an easier time finding a new job despite your injury. But if your job options are limited because you don’t have a lot of training or education, your impairment rating could be higher since your ability to earn a living is more affected.
The type, location, and severity of your injury all matter. For example, if you have a shoulder injury, doctors will check how well you can move your arm—up, down, and side to side. For back or neck injuries, they’ll assess how much you can bend, twist, or turn. The more restricted your movement, the higher your impairment rating might be.
If you’ve been hurt in more than one place, each injury is evaluated on its own and together. That’s because having multiple injuries can impact you more than just one by itself. For example, if you injure both your back and your arm, it could make working way harder than just having one of those injuries alone.
Before you get an impairment rating, you must reach MMI, meaning your condition has stabilized and isn’t expected to improve much more. This is when doctors can accurately assess your long-term limitations.
Both your doctor and the insurance company’s doctor evaluate your impairment. Your doctor gives an assessment after MMI, but the insurance company’s doctor may disagree and rate your impairment lower, which can lead to disputes.
In places like New York, doctors follow standardized guidelines to ensure fair ratings. These guidelines consider:
Some injuries—like multiple surgeries or a frozen shoulder—may get higher ratings due to added complications.
Each injury is evaluated separately, but doctors also look at how they combine to impact your ability to work.
For example, if you have both a back injury and a shoulder injury, doctors will assess each one individually—checking things like pain, range of motion, and strength. But having both injuries together can limit your work abilities more than just one would on its own. A serious back injury might already make physical work difficult, but adding a shoulder injury on top of it could make even basic tasks impossible.
Your work status also plays a big role. If your injuries prevent you from working at all, you could qualify for ongoing benefits. If you can still work but with restrictions or fewer hours, that will affect how much compensation you receive.
A workers’ comp lawyer understands the system, medical reports, and legal loopholes to fight for your best outcome. They handle paperwork, hearings, and negotiations so you don’t get shortchanged.
Your doctor and the insurance company’s doctor may disagree on your impairment rating. Your lawyer challenges the insurance doctor’s opinion, presents medical evidence, and ensures your doctor’s assessment is properly considered.
If your impairment rating seems too low, your lawyer can gather additional medical evidence and fight for a fairer assessment in court.
If a judge’s decision seems unfair, you may be able to file an appeal, but deadlines are strict. Your lawyer drafts and submits the appeal, arguing your case to correct legal errors or misunderstandings. Appeals can take months, but legal expertise improves your chances.
Settlements can happen at any time—even before reaching Maximum Medical Improvement (MMI). A lawyer helps you weigh the pros and cons, determine a fair amount, and negotiate the best deal.
Having strong legal support makes all the difference in getting the compensation you deserve.
If you had a pre-existing condition or an old injury in the same area, the insurance company may argue that your current disability isn’t fully work-related. This is called apportionment. For example, if you had a knee injury years ago and then re-injured it at work, they’ll try to divide responsibility.
You can get a second opinion if you disagree with your doctor’s assessment, but be cautious. Seeing multiple doctors just to get a better rating (doctor shopping) can hurt your case. Instead, talk to your lawyer, who can guide you on the right approach.
Settling before reaching Maximum Medical Improvement (MMI) can be tempting, especially if you need financial stability. But settling too soon could mean accepting less than you deserve, especially if your condition worsens later.
Be sure to keep everyone in the loop, this includes your lawyer, your doctor and the insurance company.
When attending medical exams, be honest about your pain and give your best effort during physical tests. Doctors can tell if someone isn’t trying, and any suspicion of exaggeration can hurt your case. Cooperation ensures your impairment rating accurately reflects your condition.
Be Honest About Past Injuries
If you’ve had previous injuries or accidents, disclose them upfront. It’s better than having the insurance company find out later and use it against you. Transparency helps protect your claim.
Give Full Effort in Medical Exams
Doctors can tell if you’re not trying your hardest, and any sign of exaggeration could hurt your case. Show genuine effort so your impairment rating reflects your real condition.
Stay Consistent
Make sure your statements to your doctor, lawyer, and insurance company match. Any inconsistencies can be used against you.
Keep Records
Save all medical documents, treatments, and case-related communication. These records strengthen your case if disputes arise.
Follow Your Doctor’s Advice
Stick to your treatment plan, or the insurance company might claim you’re not as injured as you say and try to reduce your benefits.
Keep Your Lawyer Updated
Regularly inform your lawyer about medical updates, work changes, and case developments so they can adjust your strategy.
Understand Your Impairment Rating
Your rating affects your compensation, so know how it’s calculated. If anything seems off, ask your lawyer to ensure you get what you deserve.
If you have any questions or need help with your own workers compensation case, feel free to reach out to me. I’m here to help you understand your rights and get the benefits you deserve. You can call me, Rex Zachofsky, anytime at 212-406-8989.
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