How Much Is My Case Worth?

At some point, physicians will declare your medical condition to have reached maximum medical improvement, also sometimes referred to as “permanent and stationary.” This is a statement that your condition is not expected to significantly improve or deteriorate in the foreseeable future. It also means that your workers’ compensation case is ready for a final resolution.

The value of a final medical report in workers’ compensation is based strictly on doctors’ conclusions about your impairment and the predicted medical treatment you may need in the future. The doctors who report in workers’ compensation cases are required to refer to the “American Medical Association Guides to the Evaluation of Permanent Impairment,” Fifth Edition, to assess the degree of permanent impairment.

Determining The Value Of Your Case

Permanent disability in workers’ compensation is not the same as permanent disability in a civil case. In such cases, you can recover expenses for inconvenience, pain, suffering and future loss of earnings. None of those factors are calculated in workers’ compensation.

Attorneys and judges are bound by the limitations of the California Labor Code and must utilize the rating formulas in the labor code to calculate your permanent disability following this process:

• The ratings begin with the doctor’s assessment of the type of injury involved and the calculated whole-person impairment percentage for your injury.
• The number obtained is multiplied by 1.4 for cases in which the injury occurred on or after 2013.
• The result is modified (up or down) based on your occupation and age at the date of injury.
• Your permanent disability rating is the result.

The final permanent disability rating, expressed as a percentage, may be further modified down if the doctors feel some part of your disability is due to factors other than your work injury (this is called “apportionment”). The final number equates to a certain number of weeks of payments based on your average weekly earnings at the time of injury. Still, it may not exceed certain maximum statutory limits on the weekly payment amount.

How A Workers’ Compensation Case Can Be Resolved

There are two ways to resolve a workers’ compensation case. One is to agree to the permanent disability rating and accept an award of permanent disability in the amount stated. That award will come with a provision for lifetime medical care to cure and relieve the effects of your injury.

If doctors determine that you cannot return to your usual occupation, you will have a $6,000 “voucher” for vocational training. You can use this resource to pay for tuition, books, tools and assistance from a vocational specialist to help you find a new job based on that new training. You may also have access to an additional $5,000 (not part of the permanent disability award) from a special fund created to help people displaced from their regular occupations due to injuries.

Another way to resolve a workers’ compensation case is by settlement, called a compromise and release (C&R), which is a negotiated amount that considers your permanent disability and the estimated value of your future medical care. With a C&R, medical care is closed out.

It is regularly recommended not to settle by C&R unless you have access to medical care from some means other than workers’ compensation. An insurance company will usually agree to a C&R if they believe it will be less costly for them to do so than to provide lifetime medical care for your injury.

Your Case In The Hands Of An Experienced Attorney

Each case – just like every client – is unique and merits individual attention and analysis. As you discuss your case with me, attorney Howard J. Stevens, I will carefully evaluate the reports you provide. At my firm, the Law Office of Howard J. Stevens, APC, in San Diego, I will explain your rights and potential resolutions based on my many years of experience and special training.

If you have questions about the process in order to make vital decisions about your claim, call me at 619-880-4501 to learn your options and the consequences of each choice. You can also use this contact form to schedule an appointment at my office, your home or your hospital room. Your case evaluation has no cost.