Under Arizona’s system of workers’ compensation, two important considerations are impairment ratings and disability benefits. It can be tempting to use the terms “impairment” and “disability” interchangeably, but they are different, and this difference is key to understanding how your workers’ compensation disability claim works and how much you might receive in workers’ compensation benefits.
At Matt Fendon Law Group, we provide legal assistance to Arizona workers who need to make workers’ compensation benefits claims after a work-related injury, illness, or other medical condition. In this post, we help you distinguish impairment from disability in the context of workers’ compensation.
If you need help navigating Arizona workers’ compensation, call us at (800) 229-3880 or reach us online to schedule a free consultation with an experienced Arizona workers’ compensation attorney.
What is an Impairment?
The concept of impairment relates to health issues that affect your physiological or anatomical structure or function, or to neurological damage. Your treating doctor or an independent medical examiner will evaluate and quantify your impairment once you reach maximum medical improvement (MMI) and your course of medical treatment ends.
For permanent workers’ compensation benefits, impairments are assessed generally in two ways:
- As a percentage of your whole person for “unscheduled ratings”
- As a percentage of an extremity for “scheduled ratings”.
A tool that doctors use to make this assessment is a collection of guides known as the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment.
Impairment ratings are important when calculating permanent workers’ compensation benefits for what are known as “scheduled ratings” or “unscheduled ratings.”
Scheduled Impairments
Scheduled impairments refer to a statutory list of specific kinds of injuries found in Arizona Revised Statutes (ARS) Section 23-1044(B).
Examples of scheduled impairments include loss of a thumb, finger, or toe; loss of a hand or foot; loss of vision in either or both eyes; or hearing in either or both ears.
Your impairment is assigned as a series of percentages of loss of normal function of the affected body part or system. Your impairment percentage rating starts with the affected body part and can be calculated as a percentage of your whole body.
Using the AMA Guides, impairments are converted from the affected body part to a whole-person impairment through standardized tables. The exact percentages depend on the specific medical findings and AMA methodology used.
For example:
- If you have an 8% impairment rating for a thumb impairment, this converts to a 3% hand impairment rating.
- This hand impairment converts to a 3% arm impairment rating.
- Lastly, the arm impairment converts to a 2% whole-person impairment rating. However, converting to a whole person impairment for a scheduled injury is unnecessary to determine a scheduled permanent disability award.
Unscheduled Impairments
Unscheduled impairments are not listed in the statutory schedule under ARS 23-1044(B), but are covered under ARS 23-1044(C). Examples of unscheduled impairments include back, hip, or shoulder injuries.
Unscheduled impairments still require a medical impairment rating, often determined using the AMA Guides, but compensation is based on the worker’s loss of earning capacity rather than a statutory schedule. Instead, they are evaluated based on your reduced earning capacity because of the impairment. Multiple impairments that affect different body parts become unscheduled impairments even if they include otherwise-scheduled impairments.
Certain injuries are presumed to be permanently and totally disabling (PTD). Arizona law presumes permanent total disability for certain catastrophic losses listed in ARS 23-1045(C), while other severe injuries may qualify for PTD based on medical and vocational evidence.
Payments for PTD unscheduled injuries may continue for life, with benefits calculated at 66 and 2/3% of your average monthly wage (AMW). These payments are subject to annual statutory limits and annual review.
What is a Disability?
Compared to an impairment, a disability refers to the functional limitations an injury imposes on your ability to perform your job duties and whether you can go back to your pre-injury job.
Disability refers to the restrictions and limitations an individual faces in their daily life and work due to their impairment. It takes into account not only the medical condition but also how it affects one’s ability to earn a living and perform daily tasks.
Disabilities can be temporary or permanent.
Temporary Disability
A temporary disability is when you are temporarily unable to work because of an injury, but you are expected to recover. Temporary disabilities can be total or partial, depending on whether you can perform any work during your treatment and recovery.
Permanent Disability
A permanent disability occurs when you cannot fully recover from an injury. Like with a temporary disability, this type of disability can be total or partial.
- Permanent total disability means you cannot return to any kind of work.
- Permanent partial disability means that you retain some work capability, but with significant restrictions.
How Disability Affects Your Workers’ Compensation Benefits
Impairments bear on whether your injury is scheduled or unscheduled; your disability affects what you can receive in benefits for a scheduled or unscheduled injury.
For scheduled injuries, benefits are a percentage of your AMW before your work-related injury. These benefits are paid for a fixed period based on the affected body part. Your disability is based on partial or total loss of use. This relates to a percentage of your AMW and the duration of your benefits.For unscheduled injuries, your compensation is based on your loss of earning capacity. This is calculated as 55% of the difference between your pre-injury and post-injury wages. Unscheduled permanent partial disability benefits may continue long-term, but are subject to periodic review and adjustment if earning capacity changes.
Summing Up: Key Differences Between Impairments and Disabilities
Here are the main points to remember when you consider impairments and disabilities under Arizona workers’ compensation:
- Impairment is a quantifiable loss of function. Impairment is determined using medical and AMA guides.
- Disability relates to the physical functional limitations arising from an impairment. Disability is measured through criteria like functional capacity evaluations and vocational assessments.
- Impairment ratings are used to determine eligibility for certain types of benefits.
- Disability assessments determine the extent and duration of benefit payments.
Do You Have Questions About Impairment vs Disability in Arizona Workers’ Compensation?
This blog post is meant to familiarize you as an injured worker with the most important distinctions between impairments and disabilities and how they affect your potential workers’ compensation benefits. The details can be more intricate.
For example, in some cases you might have a low impairment rating but still be unable to return to your pre-injury work, or in other situations you might have a high impairment rating that isn’t fully reflected in functional assessments for disability benefits.
Impairment and disability considerations can also affect your ability to receive certain Social Security benefits.
An experienced Arizona workers’ compensation lawyer from Matt Fendon Law Group can help you grasp a full understanding of the differences. To schedule a free consultation, call us at (800) 229-3880 or use our online contact form.