Permanent Disability Rating Lawyer in San Diego

Permanent disability rating lawyer help for San Diego workers whose QME or treating doctor report came back lower than the injury feels. The rating sets how much permanent disability you are paid, so we check how it was reached and challenge it when the evidence doesn’t hold up.

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Doctor writing on a clipboard form across from a patient, the kind of medical report a permanent disability rating is based on

How a permanent disability rating is set

When your condition stops improving, your doctor declares you permanent and stationary, sometimes called maximum medical improvement. The doctor then writes a report describing your lasting limitations, and that report becomes the basis of your permanent disability rating. The report may come from:

Your primary treating physician, the doctor managing your care
A Qualified Medical Evaluator (QME), chosen from a panel of three doctors the state issues when the two sides disagree on a medical question
An Agreed Medical Evaluator (AME), a doctor both sides choose together, which is generally an option only when you have a lawyer

For most injuries since 2005, the doctor measures your impairment using the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition. That number is then adjusted under California’s Permanent Disability Rating Schedule for your occupation and your age when you were hurt. The final rating sets how many weeks of permanent disability payments you receive, and a higher rating generally means more weeks. A rater at the state’s Disability Evaluation Unit can calculate a rating from the doctor’s report.

What permanent disability pays

Permanent disability (PD) comes on top of the medical care and temporary disability you received while recovering. In general:

PD is paid in weekly payments, or folded into a settlement. Payments generally should start within 14 days after temporary disability ends if some permanent disability is expected, based on an estimate until the rating is final.
Your lasting impairment drives the rating, not the type of accident. Two workers with the same injury can end up with very different ratings.
Future medical care is a separate question. A rating can be low while you still need treatment for years.
If you can’t return to your old job and your employer doesn’t offer other work, you may qualify for a job displacement voucher for retraining.

The rating is also the starting point for any workers’ comp settlement, whether it’s paid over time or as a lump sum. That’s why it’s worth getting the rating right before you talk about settling.

Common reasons a PD rating comes back low

A low PD rating usually traces back to something in the medical report. These are the problems we look for first:

Body parts left out. The evaluator rated your back but not the knee or shoulder hurt in the same incident, or never addressed related problems like headaches.
An incomplete record review. The doctor didn’t see your MRI, your surgical report or your treating doctor’s notes.
Apportionment. The doctor blamed part of your disability on age, arthritis or an old injury. California law requires the doctor to address this, but the opinion has to be explained and based on the evidence. A bare conclusion can be challenged.
A rushed exam. Range of motion or grip strength measured in a short visit, on a day that didn’t reflect your usual symptoms.
The wrong occupation. Your job was classified as lighter work than you actually do, which can lower the adjusted rating.
A strict reading of the Guides. In some cases the law allows a doctor to use other parts of the AMA Guides when the standard method doesn’t accurately reflect your impairment.

Spine claims raise many of these issues. If that’s your situation, see our page on back injury workers’ comp claims.

Doctor explaining exam results to a frustrated patient, the kind of visit that can end in a low PD rating or a QME dispute

How a QME dispute is handled

You don’t have to accept a report you believe is wrong. Depending on the problem, the options can include:

Asking the evaluator for a supplemental report that addresses missing records or body parts
Questioning the doctor under oath in a deposition about how the rating was reached
Relying on a better-supported report from your treating doctor
Asking a workers’ comp judge to decide which medical opinion is substantial evidence

Some of these steps have short deadlines once the report is served, so don’t set aside a report you disagree with. If the insurer is disputing whether the injury happened at work at all, that’s a different fight, covered on our page about a denied workers’ comp claim.

When to get help with your rating

Call a lawyer if any of these apply to you:

You received a QME or AME report and don’t understand what it means for your case
The report rated fewer body parts than you hurt, or blamed part of your disability on something other than work
The insurer sent a rating notice or a settlement offer based on the report
Your permanent disability payments stopped, never started, or seem too low
Your employer ignored your permanent restrictions or let you go, which may be workers’ comp retaliation

We review the report for free and explain whether it’s worth challenging. You can also see the other types of workers’ comp claims we handle.

How we handle a disability rating dispute

Step 1
Free case evaluation
Tell us what happened. We review your claim and explain your options in plain language, at no cost.
Step 2
We take over the claim
We file the paperwork, track every deadline and handle all communication with the insurance company.
Step 3
Treatment and benefits
We push for the medical care and temporary disability payments the law provides while you recover.
Step 4
Settlement or award
Once your condition is stable, we fight for a fair disability rating and settlement, or present your case to a judge.

Meet the lawyer who will handle your claim

Rodolfo WeissWorkers’ Compensation

Permanent disability rating questions

When will I get my permanent disability rating?

Usually after your doctor says your condition is permanent and stationary, meaning it isn’t expected to improve much with more treatment. That can take months or longer after the injury, especially if you need surgery. The rating comes from the doctor’s report, so the timing depends on when that exam and report happen.

Can I challenge a low QME rating?

Often, yes. Common approaches include asking for a supplemental report, deposing the doctor, or relying on a better-supported report from your treating physician, and in some cases a new evaluation. Each has its own rules and timing. A lawyer can find what in the report is driving the low rating.

What’s the difference between a QME and an AME?

A QME is chosen from a panel of doctors the state assigns. An AME is a doctor both sides agree on, which is generally an option only when the worker has a lawyer. Judges often give an AME’s opinion a lot of weight, so the choice of doctor matters.

Will I get paid while I wait for my rating?

Usually. Temporary disability continues while your doctor keeps you off work, subject to time limits. Once it ends, permanent disability payments generally should start based on an estimate if some lasting disability is expected, and they are adjusted once the rating is final.

Why did the doctor say part of my disability isn’t from work?

That’s apportionment. California law asks the doctor to estimate how much of your permanent disability was caused by the work injury and how much by other factors, such as an earlier injury. The opinion has to be explained with medical reasoning. If it isn’t, it can be challenged.

More help with your claim

Think your rating is too low?

Get a free case evaluation of your medical report and rating. You pay nothing up front.