Permanent Disability Insurance
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Workers Comp Permanent Disability
Sometimes a job-related injury or illness causes an employee to become permanently disabled or impaired. When this happens, the employee may be eligible for permanent disability payments through workers compensation coverage. Permanent disability payments are calculated based on several factors. Two factors that are taken into consideration include: How severe the physical injury is, and how much the injury or disfigurement prevents the employee from earning income in the future. Workers comp also considers how old the employee was when she received the injury, the date the injury or illness occurred, and her standard type of employment or occupation.
Changes in the Workers Comp law may also contribute towards factors that the Department of Workers Compensation (DWC) takes into consideration when determining the amount of money a permanently disabled employee is entitled to.
When employees receive permanent disability through Workers compensation, the DWC will declare two monetary awards: Benefit and maximum.
The benefit amount is the amount of money the disabled employee will receive every two weeks. The maximum amount is the total amount of money the disabled employee can receive overall. A maximum amount is reached over time as the benefits are paid. The maximum can also be reached if the employee receives a settlement payment in one lump sum.
The DWC uses a Rating Schedule to help make an assessment of what percentage the employee is permanently disabled. This schedule helps make a payment determination based on the assessment as to the extent of an employee’s limitations and impairments that were caused by work-related injuries.
The employee’s disability assessment must be made by the physician who has been treating them for the job-related injury. When the employee is being represented by an attorney, the assessment can be made by a Qualified Medical Evaluator (QME) or an Agreed Medical Examiner (AME) instead.
Employees who are not represented by an attorney may not agree with the treating physician’s disability assessment. When this happens, the employee is allowed to select an alternative physician from a panel that is provided by the DWC Medical Unit. That alternate doctor may perform the disability assessment and evaluation for the employee.
When an employee is represented by a lawyer, all parties try to agree on one AME to perform the evaluation and assessment. When an agreement cannot be reached, the DWC will appoint three QMEs to a panel, and all parties must choose from this panel. Normally the choice is made through a process of elimination.
When evaluations and assessments from physicians do not agree, the amount of money an employee receives for disability will be determined through the process of negotiation or litigation.