Losing a limb while at work can alter your life in a significant way. Due to the severity of the injury, you might wonder if you qualify for permanent total disability benefits. Recognizing how the system works can help you take the next step toward recovery.
Defining permanent total disability
Permanent total disability, or PTD, refers to a condition that leaves you completely unable to earn a living. In California, a PTD designation corresponds to a 100% disability rating and entitles you to weekly benefits for the rest of your life.
California law lists specific injuries it treats as totally disabling. These include loss of both eyes, loss of both hands, near-total paralysis and brain injuries that cause permanent mental incapacity. If your injury falls into one of these categories, you do not need to prove you cannot work.
For injuries outside that list, a PTD finding is still possible. To qualify, you typically need a vocational expert to show that your medical limitations prevent you from retraining or finding work in the open labor market.
Placing your injury within the rating schedule
California’s Permanent Disability Rating Schedule turns your medical impairment into a disability percentage. A physician first assigns a rating using the “AMA Guides, Fifth Edition”. That number is then multiplied by a standard statutory modifier and further adjusted based on your job and age at the time of injury.
The type and level of amputation matter a great deal. An index finger amputation at the middle joint may result in a rating near 11%, while loss of a hand or leg produces a much higher number.
Major amputations often lead to ratings between 50% and 90%. Those reaching at least 70% qualify you for a life pension, which provides ongoing payments after your standard permanent disability benefits expire.
Filing your workers’ comp claim
Generally, you have one year from your injury date, or the date your employer last provided benefits or medical care, to file a claim. You should also report the accident within 30 days, though exceptions exist if your employer already knew about the injury or was not prejudiced by a delayed report.
Once a doctor confirms you have reached maximum medical improvement, your case moves to a permanent disability evaluation. That rating sets your disability percentage. If you disagree with it, you can request a review from a qualified medical evaluator.