Permanent Disability Ratings & Your NC Claim
How permanent impairment ratings affect your NC car accident settlement. AMA Guides, who assigns ratings, and what your percentage actually means for your case.
The Bottom Line
After a car accident injury stabilizes, your doctor may assign a permanent impairment rating -- a percentage that represents the amount of physical function you have permanently lost. This rating is one of the most important pieces of evidence in your NC car accident claim because it provides objective, medical proof that your injury is permanent. Understanding what the rating means, how it is calculated, and how it affects your settlement helps you avoid being undervalued by insurance companies.
What Is a Permanent Impairment Rating?
A permanent impairment rating is a medical assessment that quantifies the degree of permanent physical function you have lost as a result of your injury. It is expressed as a percentage of whole-person impairment -- for example, a 10% whole-person impairment rating means you have permanently lost 10% of your total body function.
The rating is assigned by a physician after you have reached maximum medical improvement (MMI) -- the point at which your condition has stabilized and is unlikely to improve significantly with further treatment.
Impairment vs. Disability
These terms are often confused, but they mean different things:
Impairment is a medical concept. It measures the loss of physical or mental function based on objective criteria -- range of motion, strength, sensation, imaging findings, and neurological testing.
Disability is a functional and vocational concept. It measures how the impairment affects your ability to work, perform daily activities, and live your life.
You can have a significant impairment with minimal disability (a desk worker with reduced knee range of motion) or a moderate impairment with devastating disability (a concert pianist with a 5% hand impairment).
How Impairment Ratings Are Calculated
The AMA Guides
Most physicians use the AMA Guides to the Evaluation of Permanent Impairment to calculate ratings. The Guides provide standardized criteria for rating impairment across every body system.
The rating process involves:
- Physical examination -- measuring range of motion, strength, sensation, and function
- Review of imaging -- X-rays, MRI, CT scans showing structural damage
- Neurological testing -- for nerve damage or neurological impairment
- Functional assessment -- testing the ability to perform specific physical tasks
- Application of AMA Guides tables -- converting the objective findings into a percentage using the standardized criteria
Common Impairment Ratings from Car Accident Injuries
| Injury | Typical Impairment Rating Range |
|---|---|
| Resolved whiplash | 0% - 3% |
| Herniated disc (no surgery) | 5% - 10% |
| Herniated disc (with fusion surgery) | 10% - 25% |
| Spinal cord injury (paraplegia) | 50% - 75% |
| Spinal cord injury (quadriplegia) | 75% - 95% |
| Severe TBI | 30% - 90% |
| Below-knee amputation | 28% - 40% |
| Above-knee amputation | 40% - 60% |
| Shoulder replacement | 15% - 25% |
| Knee replacement | 15% - 25% |
These are approximate ranges. The actual rating depends on the specific findings and the edition of the AMA Guides used.
How Impairment Ratings Affect Your NC Claim
They Provide Objective Evidence of Permanent Harm
The most important function of an impairment rating in an NC personal injury claim is that it provides objective, medical proof that your injury is permanent. Insurance companies cannot dismiss a permanent impairment rating the way they can dismiss subjective complaints of pain.
They Influence Settlement Negotiations
While NC personal injury settlements do not follow a formula based on impairment ratings, the rating does influence negotiations:
- Higher ratings correlate with higher settlements because they document more severe permanent harm
- The rating supports future damages claims by establishing that you will live with limitations for the rest of your life
- The rating strengthens credibility -- it is harder for the insurance company to argue your injury is minor when a physician has assigned a permanent impairment percentage
They Are One Factor Among Many
In NC personal injury claims, the impairment rating is important but not determinative. Other factors that influence settlement value include:
- The total cost of medical treatment
- Lost wages and future lost earning capacity
- How the impairment affects your specific job and daily activities
- The quality of your medical documentation
- Whether contributory negligence is an issue
- The available insurance coverage
- Pain and suffering and loss of enjoyment of life
Getting the Right Impairment Rating
Choose the Right Doctor
Not all doctors are experienced in assigning impairment ratings. The physician who assigns your rating should:
- Be a specialist relevant to your injury (orthopedist for musculoskeletal, neurologist for brain/nerve injuries)
- Be familiar with the current edition of the AMA Guides
- Have experience performing impairment evaluations
- Be willing to support the rating with detailed documentation
Timing Matters
The rating should be assigned at or after MMI. If assigned too early, the rating may be lower than warranted because the full extent of permanent impairment is not yet apparent. If your doctor suggests rating you before your condition has stabilized, ask about waiting.
Get a Second Opinion If Needed
If your impairment rating seems lower than your actual limitations warrant, seek a second opinion from another qualified specialist. Different physicians may interpret the AMA Guides differently, and a more thorough evaluation may yield a rating that better reflects your permanent harm.
Frequently Asked Questions
Frequently Asked Questions
What is the difference between an impairment rating and a disability rating?
An impairment rating measures the percentage of physical function you have permanently lost. A disability rating measures how that impairment affects your ability to work and perform daily activities. You can have a significant impairment but low disability if the lost function does not affect your job.
Who assigns a permanent impairment rating?
Your treating physician, typically a specialist relevant to your injury, assigns the rating after you reach maximum medical improvement. The doctor uses the AMA Guides to calculate the rating based on objective findings.
What are the AMA Guides to the Evaluation of Permanent Impairment?
The AMA Guides is a reference manual providing standardized criteria for rating permanent impairment. Doctors use specific tables and formulas to calculate percentages based on range of motion loss, strength deficits, neurological impairment, and other objective findings.
How does a permanent impairment rating affect my NC settlement?
The rating is one of several factors influencing settlement value. A higher rating generally supports a higher settlement because it documents permanent harm. However, the impact on your daily life and work is often more influential than the percentage itself.
Can I get a second opinion on my impairment rating?
Yes. If you believe your rating does not accurately reflect your limitations, you can request an evaluation from another qualified physician. A second opinion may result in a different assessment.
When is the impairment rating assigned?
After you reach maximum medical improvement (MMI). For many injuries, MMI is reached within 6 to 12 months. For catastrophic injuries, it may take 12 to 24 months.