Difference Between Impairment and Disability

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In most of my cases, the discussion of impairment and disability isn’t an explanation I generally have to give in some of my workers’ compensation claims unless I am debating the concept with the Defendants in the case.

However, when I have a safety personnel such as CDCR prison personnel and parole officers, CAL FIRE, CHP, city and county firefighters, police officers, and deputy sheriff, this explanation is important.

When a safety personnel is substantially incapacitated from his / her essential job functions (not able to return to their job and therefore the discussion of Industrial Disability Retirement  is on the table), the explanation of the difference between impairment and disability is required in most cases.  A common misconception of safety personnel is that the disability percentage in the workers’ compensation case is connected to eligibility or pay for Industrial Disability Retirement.  Another misconception is that your percentage of workers’ compensation disability determines the percentage of your retirement, and it does not.

In order to understand your level of retirement, you should read my Industrial Disability Retirement Guide on my website by clicking here or contact my office so I can review your workers’ compensation claim and get you connected with a disability retirement attorney.

A common question I get is “what is the percentage of disability in the workers’ compensation for me to be eligible for retirement.”  My response is that “it’s unrelated.”  In order to explain this you have to understand how we in the workers’ compensation system arrive at the percentage of disability.  

It starts with a book called the AMA Guides.  Based on a medical diagnosis (knee arthritis, knee replacement, shoulder replacement, shoulder surgery, hip replacement, back surgery, degeneration in the spine, etc.), you are assigned a medical impairment percentage based on the book.  It’s very strict in nature.  That number is then put through an arbitrary math formula that considers your job duties and how they are related to the body part or body part(s) and your age.  That math formula comes out to a final number.  With some general exceptions to the rule, that medical impairment number has nothing to do with disability (again there are exceptions to the rule and I will touch on that later.)
Disability is actual work limitations that you may have as a result of that medical impairment.  You have had a knee replacement and feel really good and feel able to perform your job, however, your surgeon might say “I don’t want you responding to alarms, wrestling with suspects, walking over uneven ground, lifting over 50 lbs, etc.”  The work limitations are what determine disability or your reduced ability to perform your job.  Those work limitations will be compared to your essential job functions; if they preclude you from performing your essential job functions, then you would be substantially incapacitated from your job making you eligible to apply for Industrial Disability Retirement.

An example how impairment and disability are different is two cases I’ve had.  I had a correctional officer who had plantar fasciitis in both feet and following surgery still had problems.  The surgeon did not want this officer to return to her job yet the medical impairment was 8%.  I had another correctional officer who had LVH (a heart problem caused by chronic high blood pressure) who was allowed to return to the job and that medical impairment was 30%.  As you can see the amount of medical impairment does not necessary determine whether or not someone can return to their job or not.  It’s the disability.  The surgeon in the bilateral feet case said that this officer was unsafe to respond to alarms in her facility, so she was eligible for Industrial Disability Retirement.

I had indicated earlier that there are some exceptions to the rule.  There are two cases (Almaraz and Guzman) that allow the doctor to deviate from the strict interpretation of the AMA Guides.  In a CAL FIRE claim, I had a client who did not opt for back surgery, but this firefighter had a disc pushing on a nerve in his back.  The doctor provided a strict rating of 13% based on the book, and I got the rating increased to 19% based on his reduced ability to lift.  This rating did contemplate work limitations and impact on activities of daily living.  However, this person had other work limitations based on the back that played into his eligibility for Industrial Disability Retirement.

If you have a workers’ compensation claim and you’re a safety member, I encourage you to contact me to discuss your claim even if you are returning to work.  How you close your file could have serious impact on your future rights not only to future medical in workers’ compensation, but it could impact your retirement rights.