My Finger is Worth How Little!? How Did You Even Calculate That?

By: Holly R. Stephens

If you deal with worker’s compensation claims on a regular basis, you have probably heard of “a rating” or a “PPD” being assigned to workers’ compensation claimants in North Carolina, but what does that mean? PPD, or permanent partial disability, can be assigned by a physician and typically follows where the claimant has been placed at maximum medical improvement, otherwise known as the end of the healing period. In North Carolina, a physician will evaluate the claimant as to whether a disability rating is appropriate and assign its respective value.

Upon reaching maximum medical improvement, some claimants are not “made whole” and will continue to have some form of disability from their work-related injury. This determination is generally left to the claimant’s treating physician who will assign the percentage of impairment of the affected body part. A permanency rating between 0% and 100% to an impaired body part can be offered by the treating provider. Each body part has a specific number of weeks of a “disability period” and is outlined in N.C. Gen. Stat. § 97-31. In North Carolina, this rating is the treating provider’s estimate of the percentage of impairment of the affected body part. Limited guidance is offered to treating providers other than the North Carolina Industrial Commission Rating Guide, which was last updated in February of 2000. Once a permanency rating has been assigned by the treating physician, the rating and any work restrictions are memorialized in a Form 25R.

Practice tip: Sometimes a claimant’s treating provider will assign a rating and include that rating only in their treatment notes. Be sure to provide the claimant’s treating provider with a Form 25R to complete to memorialize the claimant’s rating. You can also assign a nurse case manager to attend the appointment and ensure that the Form 25R is completed properly, or simply send a medical questionnaire and ask for a rating to be assigned.

Once a claimant receives a permanency rating for a compensable injury, should the claimant disagree with that rating, they are entitled to seek a second opinion to this rating, pursuant to N.C. Gen. Stat. § 97-27(b). Note: This second opinion will generally be with a doctor of the claimant’s choosing and at defendants’ expense, unless ordered otherwise.

So, how do you calculate how much a claimant’s rating is worth? You multiply the employee’s injury percentage rating by the number of weeks assigned to the injured body part and then by the employee’s compensation rate. (Not sure what a compensation rate is? Check out this blog post!)

Here is an example:

Claimant receives a 5% rating to his/her left leg. Claimant’s compensation rate is $360.00. Per N.C. Gen. Stat. § 97-31, a leg is assigned 200 weeks of benefits.

Calculation: 5% x 200 = 10 x $360.00 = $3,600.00

This claimant would be entitled to $3,600.00 in permanency compensation for his/her left leg impairment in a compensable case.

If you have any questions about permanency ratings or agreements concerning permanency ratings, feel free to reach out to one of our experienced attorneys for further guidance.