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Ochoa & Calderon

What is Whole Person Impairment?

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California workers injured on the job are entitled to certain benefits. Depending on the severity and anticipated longevity of the injury, an employee may be entitled to long-term disability benefits. To determine whether an employee is eligible for disability benefits, the state assigns a “percentage” of disability based on the nature of the injury or illness, also called a disability rating. In California, the permanent disability rating depends in turn on the employee’s “whole person impairment.” To learn about whole person impairment and how it affects benefits after a workplace injury, read on. If you have suffered an on-the-job illness or injury in Southern California, call a qualified Riverside workers’ compensation lawyer for advice and representation.

Understanding Whole Person Impairment

The amount of compensation an injured worker will receive for disability depends on their assigned “percentage” of disability. In California, disability percentage depends in large part on the “whole person impairment” (WPI) of the patient. The WPI is determined by the worker’s medical evaluator. The medical evaluator may be the treating doctor, a qualified medical examiner, or an agreed medical examiner, depending on the specifics of the plan, the employee, and the employer. Under certain circumstances, a judge may appoint a physician to make the WPI evaluation.

The WPI is a rating that the doctor determines for each body part affected by the workplace injury. The doctor will make this determination based on the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, 5th Edition (AMA Guides). The WPI is a percentage rating based on the description and measurements of the patient’s physical impairments, based on corresponding percentages of impairments published in the AMA Guides.

The AMA Guides provide a method for rating each injured body part based on the doctor’s evaluation and other tests, which the evaluator will then combine into a single number based on impairment to the individual’s overall ability to perform “activities of daily living” (ADLs), excluding work. WPI is meant to reflect functional limitations, rather than disability, but it provides a basis for determining work-related disability.

Converting WPI Into Benefits

Once the WPI is established, it will be used in conjunction with other factors to establish a permanent disability value. Because WPI is focused on daily functional limitation, rather than the ability to work, additional facts are necessary to generate a disability rating.

The permanent disability rating will be generated based on factors including WPI, the type of injury, the type of job, the employee’s age, and the change in the employee’s future earning capacity. For example, an employee who works all day at a computer will get a higher disability rating based on an injury to their hands as opposed to an injury to their legs. A younger employee may be considered more able to train for new employment, while an older employee may be considered more impaired based on the same injury because retaining is less likely.

After a permanent disability rating is established, it will be converted into a dollar value. The dollar value will depend upon the average weekly wages earned by the employee. A knowledgeable California workers’ compensation lawyer can walk you through the process and help you maximize your benefits based on this complex system.

For help getting benefits after an on-the-job injury or workplace illness, call Ochoa & Calderon to discuss your case with a dedicated and professional California workers’ comp lawyer. Call 951-901-4444 in Riverside or 844-401-0750 toll-free throughout Southern California.

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