FAQ: Is There A Specific Level of Permanent Disability At Which I Will Automatically Be Medically Retired?

QUESTION:

Is there a specific level of permanent disability at which I will automatically be medically retired? 

ANSWER: 

No.  Under current Workers' Compensation law, permanent disability is assessed based on Whole Person Impairment (WPI).  The appropriate WPI for any particular injury is spelled out in the Fifth Edition of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMAGuides).  The WPI is then adjusted based on age and occupation, and a final percentage of permanent disability is determined. In an ideal scenario, this is how the rating system works.  However, there are often disputes over the permanent disability rating. 

The real determination as to the ability to return to work is made by the evaluating physician in the form of work restrictions.  The first evaluating physician will be your Primary Treating Physician (PTP).  Routinely, however, a Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME) will be involved as a result of either the employer or employee objecting to the determination of the PTP.  In the body of the report, the physician will specifically comment on the ability to return to work and will provide work restrictions.

It should be noted that there are many instances where a significant WPI is assigned, yet a full return to work is granted.  Conversely, a low WPI can be assigned, yet the injured worker is found NOT able to return to work.  We have had clients who were forced to retire with as low as a 10% disability rating.  There have also been those who have continued to work with percentage exceeding 50%.  In other words, the percentage of permanent disability does not necessarily reflect the injured worker's ability to return to work.  

Please be aware that this issue can become very complex depending on various factors.  As a general rule, though, the greater the percentage of permanent disability the more likely there will be a "return to work" issue.  However, there is no magic percentage of disability at which being retired-out is mandated.  If you have any questions regarding this issue please do not hesitate to contact out office.