In many Florida workers compensation cases the employee is seriously injured and he or she will be assigned an impairment rating in accordance with the Florida Uniform Permanent Impairment Rating Schedule. The schedule is also referred to incorrectly as the Florida Impairment Guide or Florida Disability Rating Schedule.
The impairment rating has straight forward economic consequences for a specific type of benefits called “Permanent Impairment” benefits. It should be noted that Permanent Impairment Benefits are payable regardless of whether the injured worker has returned to work. The Florida Uniform Permanent Impairment Rating Schedule dictates the number of weeks that Permanent Impairment benefits will be paid. For dates of accident after October 1, 2003, the injured worker is paid as follows:
Two weeks of impairment benefits are due for each percent of impairment up to ten percent.
Three weeks of impairment benefits are due for each percent of impairment from eleven percent through fifteen percent.
Four weeks of impairment benefits are due for each percent of impairment from sixteen percent to twenty percent.
Six weeks of impairment benefits are payable for each percent of impairment over twenty-one percent.
Permanent Impairment benefits should not be mistaken for “Permanent Total Disability” benefits.
A great deal of confusion arises when an injured worker is given a seemingly small impairment rating but they can no longer work at their former job and in some cases no job at all.
For instance, if a person has two herniated disks and has undergone surgery they will be assigned an eight percent rating under the Florida Uniform Permanent Impairment Rating Schedule, 1996 edition, at page 13, assuming they have no objective evidence of neurological impairment. Nevertheless, they may be suffering from substantial limitations in physical activities from pain which stops them from returning to their former rigorous work. In fact, the injured worker can be suffering from severe depression resulting from the on-the-job accident but the workers compensation law prohibits an impairment rating of more than one percent.
The problem develops when people use the incorrect term “disability rating” interchangeably with “impairment rating”, not understanding the difference. Disability is not assigned a rating. Disability is a vocational term and in it’s most simple terms it means “not able” to do certain things. Examples are: bend, stoop, crawl, lift weight, sit, stand, walk, etc.
Impairment ratings are an artificial number created by the legislature that have nothing to do with deciding whether the injury will stop a person from working. In the above example, an eight percent rating for a person with a desk job does not mean he won’t be able to return to work. The same eight percent rating for a block mason who has laid blocks for 35 years may never return to any work.
Disability takes into consideration many factors including physical and mental restrictions and other factors which include age, education, and job skills learned in past employment that may allow the worker to perform similar jobs.
In Florida, for accidents happening after October 1, 2003, a person is entitled to Permanent Total Disability benefits by two ways. First, there are certain conditions set forth in the law that automatically entitle a person to Permanent Total Disability benefits unless the insurance company can show that the employee is capable of employment within a 50 mile radius of their residence. The conditions are:
1. Spinal cord injury involving severe paralysis of an arm, a leg, or the trunk;
2. Amputation of an arm, a hand, a foot, or a leg involving the effective loss of use of that appendage;
3. Severe brain or closed-head injury as evidenced by:
a. Severe sensory or motor disturbances;
b. Severe communication disturbances;
c. Severe complex integrated disturbances of cerebral function;
d. Severe episodic neurological disorders; or
e. Other severe brain and closed-head injury conditions
at least as severe in nature as any condition provided in sub-subparagraphs a.-d.;
4. Second-degree or third-degree burns of 25 percent or more of the total body
surface or third-degree burns of 5 percent or more to the face and hands; or
5. Total or industrial blindness.
Second, If the injured worker does not have a condition listed above, the worker has to prove there are no jobs the worker can perform within a fifty mile radius of his residence due to his physical and mental restrictions and other factors such as age, education, job skills learned in past employment that may allow the worker to perform similar jobs.
In many instances the insurance company uses the wrong impairment rating when paying impairment benefits. More importantly, insurance companies fight paying Permanent Total Disability payments because they don’t understand that a small impairment rating is not an indication of whether an injured worker will ever return to work.