Mastering Workers’ Comp Settlement for Permanent Disability from Setback to Comeback

It is stunning to think that anyone rightfully filing a workers’ compensation settlement< for permanent disability (PD) in California can be denied. Employees have already suffered enough from a permanent on the job injury or illness. But having to face another harrowing ordeal that rightfully should be theirs is baffling. However, severe hardship brought on by any number of medical, financial, legal, administrative and employment challenges are built-in to the workers’ comp system. Thomas DeBenedetto & Associates Workers’ Compensation Attorneys in San Diego have over 33 years of experience assisting permanently disabled employees that have been denied receive maximum disability benefits. Gain a strong understanding of workers’ comp settlement for permanent disability, its existing flaws and how you can ensure you receive the most you are entitled to with this post.

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Understanding Workers' Comp Settlement for Permanent Disability

Understanding Workers' Comp for Permanent Disability

PD in workers’ compensation refers to any lasting impairment that affects your ability to work after receiving all medical and rehabilitative care possible or reaching maximum medical improvement (MMI).

There are two main categories:

  1. Permanent Total Disability: You’re unable to perform any type of work
  2. Permanent Partial Disability: You can still work, but with limitations

Employees reeling from a catastrophic work injury or illness have had their ability to earn a living significantly diminished or eliminated. PD was established to provide workers long-term disability benefits for the effects of their injuries.

A medical assessment from various criteria points out what is used to establish PD:

  • Severity of permanent impairment
  • Pre-injury wages
  • Age and occupation
  • Cost of future medical care needed

Classifications for PD are expressed in percentages that can range between 0% and 100% impairment as listed:

  • 0% – No Reduction of Ability
  • 1-99% – Represents Permanent Partial Disability
  • 100% – Represents Permanent Total Disability

Injured workers in California typically have PD ratings that fall between 5% to 30%. The higher percentage of disability translates to a greater settlement as the worker’s life and future earnings have significantly been impacted upon.

The American Medical Association (AMA) is used to assist medical examiners in determining the percentage of PD an injured worker has sustained.

A disability benefit settlement offer from the employers’ insurance carrier will follow. This is often the start where PD problems begins.

Workers’ compensation attorney, Thomas DeBenedetto shares the truth on permanent residual disability.

The Complaints about PD in California

Complaints of Workers’ Comp Settlement for Permanent Disability

Workers facing permanent partial disability or total disability often encounter issues that have brought on valid criticisms. Points highlighting common problems in this state for injured workers are:

Medical Disputes

  • Disagreement with Medical Evaluator’s Assessment

    The injured frequently disagree with the impairment level assigned by Qualified Medical Evaluators (QMEs). Employees often feel that these assessments don’t accurately reflect their condition.

  • Proving Pain and Functional Limitations

    The injured frequently disagree with the impairment level assigned by Qualified Medical Evaluators (QMEs). Employees often feel that these assessments don’t accurately reflect their condition.

  • Obtaining Future Medical Treatment

    Insurance companies may impose restrictions on future medical treatment, making it difficult for employees to receive necessary care. A medical examination or utilization review (UR) the determines medical necessity, can be a significant hurdle.

Work Issues

  • Employer Resistance

    Many workers struggle with employers who are reluctant to accommodate work restrictions. This can lead to job loss or difficulty finding new employment that fits within their medical limitations.

  • Limited Job Options

    Finding suitable employment within the worker’s capabilities with significant permanent disabilities.

  • Re-injury Concerns

    Workers may fear re-injury if they return to demanding jobs, creating a barrier to work reintegration.

Benefit Problems

Financial Hardship

Currently, the weekly benefit rate is $290 for permanent disabilities in California. Settlements from your employer’s insurance company are paid in bi-weekly increments of $580 or $1,160.00 per month. Benefit payments of the permanent disability rating schedule (PDRS) have not been raised since 2013. In San Diego, the cost of living has increased over 35% since then.

This average weekly benefit rate is insufficient. A struggle to cover basic living expenses like housing, food, and utilities occurs. Having to additionally pay for medical needs increases the financial burden. This is especially true in cases where an employee has suffered a severe impairment and is prevented from returning to their previous job or finding alternative employment.

The system has not kept up to match rising expenses. Financial strain is inevitable. A downward spiral of debt from lost wages and hardship follows from total disability.

Benefit Delays

Any delays in receiving benefits during the claims process can cause significant financial strain. Problems with receiving disability benefits on time occurs. This is especially true for disabled workers that cannot work.

Psychological Impacts

  • Stress and Anxiety

    The legal process and uncertainty about future employment often lead to significant stress and anxiety for the injured which can recovery.

  • Depression and Frustration


    Dealing with chronic pain and limitations can result in depression and frustration. These psychological impacts are often overlooked in the process.

Difficult Legal Process

The workers’ compensation system in California is notoriously complex. Regulatory laws, different entities and medical evaluations engage in a slowed process where disagreement is common policy. Employees that have been inured on-the-job are left overwhelmed and confused.

Having legal representation from an experienced work injury lawyer is essential to secure maximum settlement.

Fighting Wrongfully Denied Work Injury Cases

Fighting Wrongfully Denied Permanent Disability Cases

Consider three cases of employees denied benefits for permanent injuries suffered on the job in California.

1) Insured Client Is Injured and Gets PD Benefits Terminated

Ms. H purchased an individual disability insurance policy from the Paul Revere Life Insurance Company that would cover her at work. She suffered shoulder injury and cervical disc disease several years later after purchasing the policy. Examining doctors concluded Ms. H was totally disabled.

The insurance company disputed the results and terminated her benefits.

Ms. H was able bring action against the insurance carrier and was able to receive substantial PD benefits with the assistance of expert legal representation.

 2) Insurance Carrier Denies All PD Liability After On-The-Job Injury

A 29-year-old woman employed as a nanny accompanied her employers to help them care for their young child. She was a passenger in her employers’ vehicle when a horrific car accident occurred. She sustained a traumatic brain injury, needs 24-hour care and is now wheelchair bound for life.

The insurance carrier denied all liability for the claim.

Her work injury attorney was able to prove that her accident occurred during work and therefore eligible for disability benefits.

The insurance company agreed to settle while covering all previous medical care.

3) Employee Rejected Permanent Impairment Claim for Fulfilling Required Work Duties

Mr. V had a denied claim for stroke as well as physical injuries while employed as a truck driver. Mr. V entrusted workers’ compensation attorney, Thomas DeBenedetto in San Diego to fight for his rightful benefits.

Parties proceeded to Panel QME in Internal Medicine who opined that the stressful and demanding work of a truck driver caused and/or contributed to his stroke and resulting permanent disability. The Panel QME provided applicant with a combined 64% permanent disability for cardiac arrhythmia, Ischemic Cardiomyopathy and renal function.

In addition, applicant’s chiropractic primary treating doctor opined that the physically arduous nature of a truck driver caused injury and permanent disability to applicant’s neck and back of approximately 20%. When these disabilities are combined, applicant will receive over 70% permanent disability and will be entitled to a life pension.

Thomas DeBenedetto utilized over 33 years of legal expertise as a work injury attorney  to assist Mr. V. overcome a difficult situation.

Average Workers’ Comp Settlement for Permanent Disability

Questions on what is the average settlement for PD lead to answers on work comp settlements or the average weekly wage instead. Reporting on the average compensation value on PD claims is almost impossible to measure.

Thomas DeBendetto has taken on over 5000 permanent residual disability claims as an attorney and estimates from experience that PD settlements can typically range on the following:

  1. Bilateral carpal tunnel claims: $15,000 to $50,000.
  2. Various orthopedic injuries not requiring surgical intervention: $15,000 to $50,000.
  3. Claims involving cervical or lumbar fusions: In excess of $100,000.
  4. Claims involving bilateral knee replacements: in excess of $100,000.

Hire a Skilled Work Injury Lawyer

Seek an Experienced PD Work Injury Lawyer

Have strong legal representation in your corner from the start. Hire an expert workers’ compensation lawyer. But with so many attorneys to choose from, how can you ensure that you select the best qualified legal professional for you?

Start with a free consultation. Meet several different attorneys. Look at attorneys with a proven history to handling permanent partial disability and total disability settlement cases.

The best work injury attorney can demonstrate expertise of the law, strong negotiation skills, commitment to client advocacy, and compassion to working with injured individuals to getting their disability benefits.

A permanent impairment settlement is a lifeline for an employee that is injured for life. Leave nothing to chance. Insurance companies attempt to minimize the extent of PD to reduce a payout. Disputes over impairment ratings, treatment necessity, and a reduction of benefits are bound to follow.

Many employees permanently injured at work have been forced into poverty. Don’t end up like this. Schedule a consultation on your workers’ comp settlement for permanent disability today.

Thomas DeBenedetto, San Diego workers’ compensation attorney

Thomas DeBenedetto

Workers' Compensation Attorney

Thomas DeBenedetto has over 33 years of experience representing injured workers in California workers’ compensation claims. Based in San Diego, he focuses exclusively on workers’ compensation law and regularly publishes educational content to help injured employees understand their rights and benefits under California law.

Learn More About Thomas