We’ve been getting calls lately from people who have received workers compensation settlement offers from the insurance company for only a small fraction of what their coworkers got six months ago. Most often, the insurance company told them they had to accept a settlement because a doctor gave them a disability rating under the American Medical Association’s (AMA) Guidelines to impairment. At times an uninformed coworker told them this. This is an unfair tactic to mislead workers into taking cheap settlements. It is time to set the record straight.
No, you don’t have to accept a settlement based on the AMA Guide alone. In fact, we can’t think of a single time when you should. If you do, you are accepting way less compensation than the law says you are entitled to.
AMA impairment ratings are allowed – not required
In 2011, the Illinois Legislature allowed industry and insurance interests to make a few legislative changes to the Workers’ Compensation Act. Instead of protecting the citizens and workers of the state, the legislature allowed the insurance industry to try to cheapen the disability compensation injured workers receive if they are hurt on the job. A part of this effort included adopting laws requiring the Workers’ Compensation Commission to at least consider an impairment rating under the AMA Guidelines to Impairment if the insurance company decides to buy an impairment rating on your claim. (We’re going to dig much deeper into the AMA Guidelines in future posts . . . so stay tuned.)
AMA impairment ratings are only one factor of many in evaluating disability
There are several important facts workers need to know about this change in the law. Most notably, the AMA Guide doesn’t rate “disability.” It only rates current “impairment,” and there is a big difference between the two. You are entitled to compensation for your disability, and the AMA rating the insurance company buys is only one of many factors in determining what your disability compensation should be.
Section 8.1b of the Illinois Workers’ Compensation Act (820 ILCS 305/8.1b) sets out criteria the Commission may use to determine permanent partial disability. That law:
1. Applies only to claims for injuries on or after September 1, 2011;
2. Provides that in addition to an AMA “impairment” rating, the Commission must consider these other factors:
- Your occupation;
- Your age;
- Your future earning capacity; and
- Evidence of disability in your medical records.
These other factors obviously require an analysis of substantial additional information, such as height, weight, existing physical limitations, education, past work experience, transferable skills, and a lot of other considerations that relate to whether and to what extent you are able to perform your occupation and/or expect to have future loss of earning capacity as a result of the disability from your injury. All of these factors are much more important in determining your disability than a rating of your current impairment.
Don’t let the ant swallow the elephant! Don’t let the insurance companies cheat you out of fair compensation. Educate your coworkers and don’t settle your claim cheap. Insist that you be paid the full compensation you are entitled to.