Your permanent disability (PD) rating is the most important number in your California workers’ compensation case. It will determine how much money you get. This percentage determines how much money you get, how long you get it, and how much power you have in settlement talks.
Knowing how PD ratings work and what makes them go up or down can mean the difference between getting a fair settlement and losing thousands of dollars. If you’re looking for the best workers compensation attorney to help navigate this process, understanding these ratings is crucial.
What a “Permanent Disability Rating” Means in California
A permanent disability rating is a percentage that shows how much your work-related injury has permanently made it harder for you to find work in the open labor market. This isn’t just a way to figure out how bad your health is; it’s a complicated formula that turns your disability into a number that tells you how much money you can get back.
Your PD rating percentage controls three important things:
- How many weeks you’ll be paid: A higher percentage means more weeks of pay.
- Amount of weekly payment—within legal limits based on your wages and the date of your injury
- Settlement leverage: Higher ratings give you more power to negotiate.
According to Legal Aid at Work, even small changes in your rating percentage can mean thousands of dollars in benefits. A 25% rating could mean 15 to 20 more weeks of payments than a 30% rating.
Important people in your PD rating:
- The treating doctor does the first impairment assessment.
- QME/AME: Uses AMA Guides to do a formal evaluation.
- DEU: A state agency that gives official ratings (learn more at the Disability Evaluation Unit).
- Claims administrator: an insurance company that might disagree with ratings
- WCAB judge: settles disagreements when both sides can’t agree
The Law: What Rules Apply to Your Date of Injury
The rules that apply to your case depend on when you were hurt. January 1, 2013, is the most important date.
California Labor Code Section 4660 applies to injuries that happened before January 1, 2013. It takes into account the type of injury, the person’s job, their age, and their future earning potential using the AMA Guides 5th Edition.
Section 4660.1 made big changes for injuries that happened on or after January 1, 2013:
- Removed adjustments for Future Earning Capacity (FEC)
- Added a 1.4 adjustment factor to Whole Person Impairment
- Limited some extra conditions from raising ratings
For detailed information about these regulations, consult the Schedule for Rating Permanent Disabilities from the California Department of Industrial Relations.
What the 1.4 Modifier Means
After 2013, your medical impairment (WPI) is multiplied by 1.4 before any adjustments for age or job are made. For instance, a 30% WPI becomes 42% “modified WPI” according to the published chart, and then it is changed again based on your age and job. Working with an experienced workers compensation lawyer can help ensure this calculation is done correctly.
Things You Should Know About Restrictions After 2013
After January 1, 2013, the following things can’t raise your PD rating:
- Sleep problems caused by the injury to the body
- Sexual dysfunction resulting from the physical injury
- Most psychiatric disorders arise from physical injuries
Important exceptions where these conditions still apply:
- Injuries from violent acts (workplace assaults, active shooters)
- Catastrophic injuries are those that cause 70% or more permanent disability, such as amputations, severe burns, severe head injuries, paralysis, or other injuries.
If your case falls into one of these exceptions, psychiatric and secondary conditions can raise your rating by a lot. A skilled workers compensation attorney can help determine if your case qualifies for these exceptions.
The PD Rating Pipeline: How It Works (Medical Impairment → Final Percentage)
Step 1: Getting to Permanent and Stationary (P&S)
Before you can get a PD rating, your condition must be declared Permanent and Stationary. This means that it has stabilized and more treatment won’t make it better. This doesn’t mean you’re better; it just means that your permanent limits can now be measured.
Step 2: Medical Impairment to Whole Person Impairment (WPI)
The AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, are used by doctors to figure out how much your permanent impairment is. The Guides figure out how much function has been lost by:
- Lack of range of motion—measured in degrees
- Loss of strength—grip strength and manual muscle testing
- Damage to the nerves – Problems with the senses and movement
- Surgical procedures – Initial impairment metrics
- Objective results: MRI, CT, and EMG tests
The AMA Guides stress the importance of objective medical evidence. Subjective complaints alone seldom produce substantial WPI. This is why it’s so important to keep detailed medical records during treatment. If you’ve suffered an orthopedic injury or TBI injury, comprehensive medical documentation is especially critical.
Step 3: Changing WPI into a percentage of permanent disability
California’s Permanent Disability Rating Schedule changes the rating based on the following after figuring out WPI and adding the 1.4 modifier for injuries that happened after 2013:
- Different jobs get different adjustments based on their occupation. When it comes to WPI, a warehouse worker with a spine injury usually gets bigger upward adjustments than an office worker with the same WPI.
- Age: Older workers usually get bigger adjustments because they have less time to learn new skills and find it harder to compete in the job market with restrictions.
The Disability Evaluation Unit (DEU) uses these numbers to make official rating decisions that are very important in court cases and settlement talks.
High-Impact Factors That Affect the Rating (Where Money Is Won or Lost)
Apportionment: How Much Is “Industrial” and How Much Is Prior Causes
Apportionment breaks up your permanent disability into different causes. Insurance companies will only pay for the part of your injury that was caused by your work, not for any pre-existing conditions or injuries.
If you have a 40% PD rating but the doctor says that 50% of it is due to pre-existing degeneration, your industrial PD drops to 20%, which means your benefits are cut in half.
For valid apportionment, you need:
- A lot of medical proof that a condition existed before
- Clear analysis of cause
- Not speculation, but reasonable medical probability
Challenge unsupported apportionment with:
- Fill out all of your previous medical records. If there are no records of previous problems, the apportionment weakens.
- A treatment history that shows you had no symptoms before the injury
- Extra medical reports thinking about how to divide things up again
- Second opinions from doctors
One of the best ways to raise the value of a settlement is to fight against unfair apportionment. A best workers compensation attorney can challenge improper apportionment determinations.
Limitations on work vs. rating
A lot of injured workers get permanent work restrictions and permanent disability ratings mixed up. They are related, but they have different uses:
- PD rating—decides cash benefits
- Work restrictions mean that you can’t do certain things at work, like lifting, bending, or standing.
You might have a low PD rating but a lot of restrictions that make it harder to settle because of future medical needs and Supplemental Job Displacement Benefits. For drivers injured on the job, these restrictions can be particularly significant.
How the Money for PD Benefits Is Paid
There are three things that go into figuring out PD payments:
- PD rating percentage: This is what determines how many weeks you get paid.
- Average weekly wages set the weekly benefit rate.
- Date of injury: sets the lowest and highest benefit caps
For injuries that happen between 2024 and 2026:
- At least $160 a week
- The most you can make is about $290 a week.
Calculation: Two-thirds of the average weekly wage, but not more than the legal limit
Pensions for life
Workers with PD ratings of 70% or higher may be able to get life pension payments that last for their whole life and go up every year to keep up with wage increases. These payments are worth a lot more than lump-sum settlements. If you qualify for these benefits, consult with a workers compensation lawyer to understand your options.
Stipulations vs. Compromise & Release: What Are Your Options?
Terms with a Request for Award
What it has:
- Agreement on the percentage of PD and the right to continue getting medical care for the injury.
When it makes sense:
- You’ll need ongoing care, which may include prescriptions, therapy, and even surgery.
- Your condition could get worse over time.
- Future medical costs are higher than what insurance will pay for a C&R
Compromise & Release (C&R)
What it has:
- A lump sum payment that includes PD benefits and extra money for giving up future medical rights. Everything shuts down.
When it makes sense:
- Your health is stable, and you won’t need much more treatment in the future.
- The C&R offer is much higher than the Stip value plus reasonable future medical costs.
- You want to get away from workers’ compensation for good.
Medicare Set-Aside (MSA)
If you are on Medicare or will be eligible for it in the next 30 months, C&R settlements may require you to set aside money for future medical care related to your injury before Medicare will pay. This lowers the amount of cash you actually get. For healthcare workers who are Medicare-eligible, this is an important consideration.
Get the Most Out of Your Settlement: Legal and Practical Ways to Raise the Value of Your Case
Make the Record Before the Rating Is Set In
Complete reporting of symptoms: From the first visit, be honest about all of your symptoms and how the injury affects your daily life and work. Medical records that show consistent, well-documented symptoms support higher WPI ratings.
Documenting job duties accurately: Your job title doesn’t determine how well you adjust to your job; your actual duties do. Give detailed descriptions of the physical requirements, daily tasks, and common activities.
Make sure that medical reports cover:
- Causation (work-relatedness)
- Objective results (imaging, range of motion, strength testing)
- Functional limitations (certain restrictions)
- Medical care needed in the future
- Analysis of apportionment
Use the QME/AME Process Wisely
What to bring:
- Full list of signs and symptoms
- A written record of injuries and treatments
- All of the medications you are currently taking
- Records of past injuries
- What the job is about
Don’t make things inconsistent:
- Before the exam, look over your medical records. Explain your symptoms in a way that is consistent with what your doctor has written and said before. Inconsistencies are bad signs and lower ratings.
Fix mistakes in the facts:
- If there are mistakes in the QME/AME report, your lawyer can ask for extra reports that fix the mistakes and include proof.
Don’t Leave Money Behind
Value in the future for medicine: Even low PD ratings can lead to large C&R settlements if you will need expensive treatment in the future.
Penalties for benefits that are late: When claims administrators unreasonably delay or deny benefits, penalties can make the settlement worth 10–25% more or even more. Keep track of every delay. According to the California Department of Industrial Relations, understanding your rights regarding benefit delays is essential.
Mistakes That Lower PD Ratings and Settlements
Not getting enough care or having gaps in care—Insurance says that gaps mean the injury isn’t serious.
Not reporting symptoms early enough – What you tell doctors at first stays on record for good.
Not challenging the apportionment – A lot of people just go along with whatever the doctor says about their share.
Accepting low ratings without a DEU rating or a legal review – A short consultation with a best workers compensation attorney can show you if you’re missing out on money.
Questions and Answers
“What is a good PD rating in California?”
It depends on what kind of injury you have. Moderate injuries, like shoulder surgery or single-level surgery, often get ratings below 25%. Most of the time, ratings of 25–50% mean serious injuries like multi-level fusion or joint replacement. When ratings are over 50%, they usually mean that more than one body part is hurt or that the injury is very bad. What matters is if your rating is a true reflection of your disability.
“Is it possible to raise my PD rating?”
Yes, before it’s final, through extra medical reports, challenging the division of assets, or fixing mistakes. In general, no, unless there are very special circumstances. It’s very important to get it right the first time. Consult with a workers compensation attorney to explore your options.
“Do mental injuries make PD worse?”
Yes, for injuries that happened before 2013. For injuries that happened after 2013, no, except for injuries from violent acts and injuries that are very bad. For cases involving psychiatric injuries, the specific date of injury is critical.
“Should I settle with C&R or Stips?”
If you need ongoing treatment or your condition might get worse, choose Stipulations. If your condition is stable, you don’t need much in the future, and the offer is much higher than the Stip value plus future medical costs, choose C&R.
“Is it possible for me to work while getting PD payments?”
Yes. PD benefits are for people who can’t work anymore, not for people who are currently employed. You can still get PD checks even if you work. For slip and fall accidents or other workplace injuries, this flexibility can be valuable.
What to Bring for a Free Case Review
To get an accurate case evaluation, you need to collect these documents:
- Medical reports (from the treating doctor, the QME/AME, and imaging)
- Job description that lists real work duties
- Wage records from before the injury
- Information about past injuries
- DEU score (if you got one)
- Correspondence with the claims administrator
Disclaimer
This guide is for educational purposes only and is not legal advice about permanent disability ratings in California workers’ compensation. This is not legal advice. Every case is different and has its own set of facts that need to be looked at separately. Talk to a knowledgeable workers’ compensation lawyer for advice about your specific case.
Are you ready to talk about your case? Call ODG Law Group now for a free consultation. Our knowledgeable workers compensation lawyers will look over your medical records, check your PD rating, and help you figure out how to get the most money out of your settlement.