Workers’ compensation benefits may include payments for permanent disability or loss of earnings when you have a lasting physical or mental limitation (or “impairment”) as a result of a work-related injury or occupational disease. But states have different methods for deciding how much permanent disability benefits you may receive—and how long the payments will last. For anything less than total permanent disability, most states use schedules for impairments to certain parts of the body. For impairments that aren’t listed—and in states that don’t use these schedules at all—partial permanent disability benefits are calculated under other formulas or guidelines. It can get complicated, but here’s how it generally works.
How Workers’ Comp Decides on Your Level of Permanent Disability
Once you’ve reached a plateau in your recovery—meaning you aren’t likely to get any better—your doctor will decide if you have permanent limitations and, if so, to what degree. If the doctor says you’re totally and permanently disabled under the definition in your state, you’ll usually receive checks for the rest of your life, in an amount based on a percentage of your earnings before your injury. If you’re partially disabled, the doctor will typically assign a “rating” or percentage of your impairments. Your employer’s insurance company may disagree with that rating and request an independent medical examination (IME). If the IME doctor gives you a lower rating, you could be facing a drawn-out legal battle over your permanent disability benefits.
Scheduled Awards: Permanent Disability Based on Loss of Use in Table
In states that use scheduled permanent disability awards, the schedule is a table listing specific parts of the body (such as an arm, hand, shoulder, leg, foot, eye, or ear), along with the maximum duration of permanent disability payments, usually in terms of weeks. If you’ve lost all use of that body part, you’ll receive benefits for the maximum number of weeks. If you’ve lost only partial use, the duration of your benefits would be proportional to the percentage of that loss. For example, New York’s schedule allows 312 weeks of benefits for 100% loss of an arm; if you've lost 50% use of an arm, you would receive benefits for half of that time, or 156 weeks (N.Y. Workers’ Comp. Law 15 (2018)).
While you’re receiving these benefits, the amount of each check will typically be about two-thirds of your average weekly wages before your injury, up to a legal maximum that’s usually tied to statewide average earnings. Some states use different measures to determine the amount of payments under scheduled awards, such as:
- 55% of your pre-injury wages in Arizona (Ariz. Rev. Stat. § 23-1044 (2018))
- 80% of your after-tax pre-injury wages in Michigan (Mich. Comp. Laws § 418.361 (2018)), or
- 100% of the statewide average weekly wage in Ohio (Ohio Rev. Code § 4123.57 (2018)).
Washington uses a different method entirely. The state publishes a schedule with a total dollar amount of permanent disability benefits for amputations of certain body parts (Wash. Rev. Code § 51.32.080 (2018)). To figure out your total scheduled award in most other states, you would multiply your weekly benefit amount by the total number of weeks that you’re entitled to receive benefits.
Permanent Disability Awards Not Based on a Schedule
Of course, many kinds of work injuries and occupational illnesses—like back problems, repetitive stress injuries, head injuries, or respiratory conditions—don’t fit into the neat categories of scheduled awards. And some states—including big ones like California, Texas, and Florida—don’t use scheduled awards at all. In these states, and for impairments not listed on schedules, there are different approaches to calculating benefits for permanent partial disability. The specifics vary from state to state. But in general, benefits are based on one of two methods, or a combination of those methods:
- Degree of overall impairment. Under this common method, doctors will use published guidelines to decide the extent of your overall impairment or disability. Some states include other factors in the permanent disability rating along with your physical or mental limitations; for example, California's rating guidelines also take into your age and occupation (Cal. Labor Code § 4660.1(a) (2018)). Typically, your disability rating will be plugged into a table or formula to determine how long your benefits will last. In Texas, for instance, “impairment income benefits” continue three weeks for each percentage point of overall impairment; after the end of that period, you might be eligible for supplemental income benefits (Tex. Labor Code §§ 408.121, 408.142 (2018)). The amount of each check is generally based on a percentage of your pre-injury wages, similar to the amount in scheduled awards.
- Lost earnings or ability to earn. Several states base unscheduled permanent disability awards on an estimate of how much your injury has reduced your earning capacity. This method will take into account the extent of your permanent limitations, as well as other factors like your education and work skills. In another twist on this approach, a handful of states base your benefits on the actual difference between your pre-injury wages and what you’re currently earning. In both cases, you’ll receive a percentage of the reduction in earnings or earning capacity; the benefits will usually last as long as you still have a disability.
- Mixed methods. A few states use a mix of impairment level and lost earnings (or earning capacity) for unscheduled awards. In Florida, for instance, the weekly amount of permanent impairment benefits will equal 75% of the average temporary total disability benefits you received, but it will be reduced by 50% for each week when you earn at least as much as your pre-injury wages. (Fla. Stat. § 440.15(c) (2018).)
Learning More and Getting Help
To find out the details of the rules in your state for determining permanent disability benefits, you can use the U.S. Department of Labor’s map tool to find your state’s workers’ comp agency. Most state agencies provide handbooks, assistance, and other information on their websites.
However, if you have a dispute with your employer’s insurance company about your permanent disability rating or benefits, you should talk to an experienced workers’ comp lawyer right away. An attorney can explain how your state’s rules apply to your situation, help you prepare for the IME, challenge the rating proposed by the insurer’s IME doctor, and help you get all of the benefits you're entitled to under the law. For tips on how to find a good attorney, see our article on selecting a workers’ comp lawyer.