How Your Permanent Disability Rating Is Calculated in California

Why Your PD Rating Matters

Every dollar of your permanent disability award flows from one number: your PD rating, expressed as a percentage from 0% to 100%. Under Labor Code §4660, California uses a specific formula to convert your medical impairment into a disability rating, and that rating into dollars. A difference of just a few percentage points can mean thousands -- sometimes tens of thousands -- of dollars.

For example, a 25% PD rating for a worker earning average wages might be worth approximately $25,000 in disability benefits. Bump that to 30%, and the value could exceed $35,000. At higher ratings, the jumps become even more dramatic. Understanding how the system works gives you the power to ensure you receive a fair rating.

The PD Rating Process: Step by Step

California's permanent disability rating system involves multiple steps, each building on the last. Here is how your impairment becomes a dollar figure:

Step 1: Medical Evaluation and the WPI

Everything starts with a medical evaluation. Once your treating physician determines you have reached Maximum Medical Improvement (MMI) -- meaning your condition has stabilized and is unlikely to improve further -- a doctor evaluates your permanent impairment using the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition.

The AMA Guides provide standardized criteria for measuring impairment across every body system. The doctor examines you, reviews your medical records, and assigns a Whole Person Impairment (WPI) percentage. This number represents how much your work injury has permanently impaired your body as a whole.

For example:

• A herniated disc with radiculopathy might receive a WPI of 10-25%
• A knee replacement could be assigned 15-30% WPI
• Carpal tunnel syndrome after surgery might be rated at 3-10% WPI
• A shoulder injury with chronic limitations might receive 7-20% WPI

The WPI is a medical opinion, and opinions vary. This is why the evaluating physician matters enormously -- different doctors can look at the same injury and assign different WPI values.

Step 2: Adjustments Using the PDRS

California does not use the raw WPI as your disability rating. Instead, the WPI is run through the Permanent Disability Rating Schedule (PDRS), which applies adjustments based on how your specific impairment affects your ability to work. The 2005 PDRS (used for injuries on or after January 1, 2005) incorporates several modifying factors.

Step 3: The FEC Rank (Future Earning Capacity)

The Future Earning Capacity (FEC) adjustment is a critical modifier. It accounts for how your disability affects your ability to compete in the open labor market. The FEC is expressed as a number from 1 to 15, with higher numbers indicating greater impact on earning capacity.

The FEC factors in:

• Functional limitations: What physical or mental activities can you no longer perform?
• Vocational impact: How do your limitations affect the types of jobs available to you?
• Adaptability: Can you be retrained for different work?

A higher FEC rank increases your disability rating. For instance, a 10% WPI with an FEC of 8 produces a higher PD rating than the same 10% WPI with an FEC of 4.

Step 4: Occupation Group Adjustment

The PDRS classifies workers into occupation groups based on the physical demands of their job. A construction laborer's identical injury will typically receive a higher PD rating than an office worker's because the physical demands of construction work are greater, and the disability has more impact on their ability to perform their occupation.

Occupation groups range from sedentary (Group 110) to very heavy labor (Group 590). Your specific job classification matters, so it is important that your occupation is accurately described in the medical report.

Step 5: Age Adjustment

Your age at the time of injury affects your PD rating. Older workers generally receive higher ratings because they have less time to adapt, retrain, or recover lost earning capacity. The PDRS provides age adjustment factors for each year of age.

For example, a 55-year-old worker with a 15% WPI will receive a higher PD rating than a 30-year-old worker with the same WPI, all other factors being equal. This reflects the economic reality that older workers face greater difficulty finding alternative employment.

Step 6: Apportionment

If you have a pre-existing condition or prior injury, the insurance company may seek to reduce your PD rating through apportionment under Labor Code §4663 and Labor Code §4664.

Apportionment divides your total disability between work-related and non-work-related causes. If a doctor determines that 60% of your back disability is from your work injury and 40% is from pre-existing degeneration, your PD rating is reduced by 40%.

Calculating the Dollar Value

Once your final PD rating is established, California law converts it to dollars using a formula based on Labor Code §4658. The calculation depends on three factors:

• Your PD percentage: Higher percentages mean more money per week and more weeks of payment
• Your weekly rate: Based on your pre-injury earnings, subject to statutory minimums and maximums
• Number of weeks: Determined by your PD percentage using the PDRS payment schedule

How PD Payments Scale

California's PD payment structure is not linear -- it accelerates at higher disability levels:

Note: Exact values depend on your date of injury and specific earnings. Workers with injuries at 70% or above may qualify for a life pension -- ongoing weekly payments for the rest of their life, in addition to the standard PD payments.

The SJDB Voucher: An Additional Benefit

If your PD rating is above 0% and your employer cannot offer you modified or alternative work, you are also entitled to a Supplemental Job Displacement Benefit (SJDB) voucher worth $6,000. This voucher can be used for retraining, skill enhancement, or education at accredited institutions. An additional $5,000 return-to-work supplement may also be available through the Return-to-Work Fund administered by the Department of Industrial Relations.

QME vs. AME: Who Rates Your Disability?

The doctor who evaluates your permanent impairment has enormous influence over your PD rating. In California, there are two types of evaluating physicians:

Qualified Medical Evaluator (QME)

A QME is a physician certified by the Division of Workers' Compensation Medical Unit to perform medical-legal evaluations. QMEs are used when you do not have an attorney, or when you and the insurance company cannot agree on a doctor. Under Labor Code §4060, a panel of three QMEs is randomly generated, and you choose one from the panel.

Key facts about QMEs:

• Randomly assigned from a panel of three doctors
• Must be certified by the DWC Medical Unit
• Their reports carry significant weight with judges
• You or the insurer can object to the report and request supplemental reports

Agreed Medical Evaluator (AME)

An AME is a physician that both you (through your attorney) and the insurance company mutually agree upon. AMEs are only available when you have legal representation. The advantage of an AME is that both sides have input in selecting the evaluator, and AME reports are generally given even more weight than QME reports.

Key facts about AMEs:

• Mutually agreed upon by both sides
• Often specialists with extensive experience in your specific injury type
• Their reports are very difficult to challenge
• Can resolve disputes more quickly than the QME process

Common Rating Disputes

PD rating disputes are among the most contentious issues in workers' comp cases. Here are the most common areas of disagreement:

WPI Disagreements

The treating physician says your WPI is 18%. The insurance company's doctor says it is 8%. This 10-point gap could mean a difference of $15,000 or more. Resolution typically requires a QME or AME evaluation, and potentially a hearing before a judge.

Apportionment Battles

The insurer argues 50% of your disability is from aging or pre-existing conditions. Your doctor says work caused 90% of the problem. Apportionment disputes under Labor Code §4663 often require detailed medical evidence and legal argument.

Occupation Group Classification

If the evaluating physician classifies you in the wrong occupation group, your PD rating could be significantly lower. A worker who performs heavy lifting should not be classified as "sedentary." Your attorney can correct misclassifications by providing detailed job descriptions and physical demand analyses.

Multiple Body Parts

When you have injuries to multiple body parts (for example, back and knee from the same accident), the ratings are combined using the "Combined Values Chart" from the AMA Guides. This combination is not a simple addition -- a 15% back rating plus a 10% knee rating does not equal 25%. The combined value is calculated using a specific formula that accounts for overlap.

Walkthrough: A Real PD Rating Calculation

This example illustrates why occupation and age adjustments matter so much. The same injury, rated at the same WPI, produces dramatically different outcomes based on the worker's circumstances.

Common Mistakes That Lower Your PD Rating

Many injured workers unknowingly hurt their PD rating through avoidable mistakes. Here are the most damaging errors we see:

How to Maximize Your PD Rating

While you cannot fabricate or exaggerate a disability (and should never try), there are legitimate strategies to ensure your rating accurately reflects your impairment:

• Be thorough with your evaluator: Describe your worst days, not your best. Report all symptoms, limitations, and functional losses. Do not minimize your condition
• Provide complete medical records: Ensure the evaluating physician has access to all imaging, surgical reports, and treatment records
• Accurately describe your job: Your occupation group classification depends on a correct description of your physical job demands. Bring a detailed job description to your evaluation
• Document functional limitations: Keep a diary of activities you can no longer perform, tasks that cause pain, and how your daily life has changed
• Hire an experienced attorney: An attorney who understands the PDRS can identify rating errors, challenge unfair apportionment, and ensure the correct occupation group is applied
• Get a second opinion: If your QME report seems low, your attorney can obtain supplemental reports or request a new evaluation

What Happens If You Disagree With Your Rating

If you believe your PD rating is too low, you have options:

Object to the Medical Report

You can file objections to the QME or AME report within 30 days. Common objections include incomplete examination, failure to consider all medical evidence, incorrect AMA Guides application, or unsupported apportionment opinions.

Request a Supplemental Report

Ask the evaluating physician to address specific issues or reconsider certain findings. Provide additional medical evidence that supports a higher rating.

Take It to Trial

If informal resolution fails, your case goes before a Workers' Compensation Administrative Law Judge. The judge reviews all medical evidence, hears testimony, and issues a Findings & Award. Judges have the authority to adopt, reject, or modify medical opinions on PD rating.

Appeal

If you disagree with the judge's decision, you can petition the Workers' Compensation Appeals Board (WCAB) for reconsideration. Further appeals can go to the California Court of Appeal.