Permanent Disability at Private, Self-Insured Firms: A Study of Earnings Loss, Replacement, and Return to Work for Workers' Compensation Claimants

By Robert T. Reville; Suzanne Polich et al. | Go to book overview

CHAPTER 6
RESULTS ON EARNINGS LOSSES AND REPLACEMENT RATES
BY SEVERITY OF INJURY

Over the years, California has developed a complicated formula used nowhere else that attempts to rank the severity of physical impairments in terms of their impact on workers (categorized by age and occupation). This ranking is done to ensure that those with the greatest loss of ability to compete in the labor market receive the largest compensation.

In particular, upon the worker s reaching permanent and stationary status, after which no further improvement is expected, a medical report is obtained with information on the impairment and in some instances a doctor s assessment of the need for work restrictions and an assessment of the worker s injury-associated pain is obtained. This information, along with the age and occupation of the worker, is then scaled and weighted to provide a disability rating that ranks workers by the severity of their disability so that the level of benefits can be set to compensate the appropriate fraction of their loss.1

By comparison, many other states take a much more rigid approach to compensating disability, emphasizing objective medical criteria for the determination of impairment, and typically ignoring work restrictions, pain, and pre-injury occupation.2

California s liberal construction of disability is controversial. On the one hand, if successful in targeting benefits to workers with a greater loss of ability to compete in the labor market, it may lead to greater equity. More workers with a disability (but without associated objective medical conditions) can receive benefits. Among those with a disability, if subjective and nonmedical factors are important and correctly scaled by the disability rating, then benefits will be distributed more effectively to those with the greatest losses, thereby achieving greater equity.

____________________
1
For example, for back injuries, the most common of the permanent partial disabilities in California, the disability rating gives a measure of a doctor s assessment of the seriousness of the injury. For instance, a 39-year-old claimant with a back injury precluding very heavy lifting will receive a rating of 10. If the injury precludes heavy work the rating is 30. If the injury results in a disability resulting in limitation to sedentary work, the rating is 70. In another example, the loss of a ring finger results in a rating of 6, while the loss of all five fingers on one hand leads to a rating of 55. The loss of hearing in one ear gets a rating of 15, while total deafness receives a rating of 60. Disability ratings below 20 are sometimes referred to as minor and ratings above 20 as major.
2
See Barth and Niss (1999) for a discussion of permanent partial disability compensation in other states.

-49-

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