PERMANENT DISABILITY BENEFITS OVERVIEW
If your treating doctor says you will never recover completely or will always be limited in the work you can do, you may have a permanent disability. This means that you may be eligible for permanent disability (PD) benefits.
PERMANENT DISABILITY BENEFITS FAQ
When you reach a point where your medical condition is not improving and not getting worse, your condition is called “permanent and stationary” (P&S). This is referred to as the point in time when you have reached maximal medical improvement (MMI). When this happens, your primary treating physician writes a P & S report.
The P & S report should describe specific medical problems, limits on the work you can do, medical care that you may need in the future for your injury, whether you are able to return to your old job, and an estimate of how much your disability is caused by your job compared to how much it is caused by other factors.
To be eligible for permanent disability benefits in California, your doctor must write a P & S report. If you’ve completely recovered and can go back to work without any limitations, you won’t be eligible for PD benefits. However, you may be entitled to compensation if your injury or illness has left you with permanent physical or mental limitations on the work you can do. In workers’ compensation, this is called “permanent disability.”
A “rating” is a percentage that estimates how much your disability limits the kinds of work you can do. It determines the amount of your PD benefits. A rating of 100 percent means that you have a permanent total disability. Ratings of 100 percent are very rare. A rating between 1 percent and 99 percent means you have a permanent partial disability. Most injured workers do not have a permanent disability, and those who do usually have ratings between 5 percent and 30 percent.
When a doctor writes a P & S report, he or she must rate your “impairment,” or how much you have lost the normal use of injured parts of your body. The doctor’s methods for rating your impairment must follow guidelines published by the American Medical Association (AMA).
PD benefit amounts are set by law and based on several factors such as the rating of your disability, your date of injury, your age and your wages before you were injured.
You are eligible to receive the total amount of your PD benefits spread over a fixed number of weeks if you have a permanent partial disability, or over the rest of your life if you have a permanent total disability.
The first PD payment is due within 14 days after the final TD payment or within 14 days after the claims administrator learns that you have a permanent disability caused by your injury. After the first payment, PD benefits must be paid every 14 days.
If your employer offers you work that pays at least 85 percent of the wages and benefits that you were paid at the time of injury or you are working in a job that pays at least 100 percent of the wages and benefits that you were paid at the time of injury, you will not receive PD payments until after a workers’ compensation judge approves a settlement of your case or decides on the PD benefits you will receive.
PD payments end when you reach the maximum amount allowed by law or when you settle your case and receive a lump sum.