Impairment Ratings in South Carolina Workers' Comp: MMI, the Body Part Chart, and What Your Rating Is Worth

An impairment rating is a percentage a doctor assigns once you reach maximum medical improvement (MMI), measuring how much permanent loss of function you have in an injured body part. In South Carolina, that rating is an important piece of evidence used along with the state's body part chart (S.C. Code Section 42-9-30) and your weekly compensation rate to determine permanent disability benefits. For example, a 20 percent rating to the arm is worth 20 percent of the 220 weeks the law assigns to an arm. The Workers' Compensation Commission makes the final decision, and it isn't bound by any one doctor's rating, so a rating that seems too low can often be challenged.

Received an impairment rating that doesn't seem right? Before you sign anything, call our office for a free consultation at 803-790-2800 (Columbia) or 843-427-2800 (Myrtle Beach).

What Is Maximum Medical Improvement (MMI)?

\Maximum medical improvement, or MMI, is the point when your doctor decides that more treatment isn't expected to make your condition significantly better. It doesn't mean you're fully healed, and it doesn't mean you'll never need medical care again. It means your condition has stabilized, and the doctor expects it to stay about the same.

Reaching MMI is a turning point in a workers' comp case because:

• Your temporary disability checks may stop. Once you're at MMI, the insurance company may ask to end your weekly checks. Here's more on how workers' comp checks work.
• Your doctor assigns an impairment rating. This becomes an important piece of evidence in determining your permanent disability benefits.
• Settlement discussions often begin. They commonly take place after MMI, once the permanent effects of the injury are better understood.

What Is an Impairment Rating?

An impairment rating is a percentage, from 0 to 100, that reflects how much permanent loss of function you have in an injured body part or in your body as a whole. Doctors look at factors like:

• Loss of strength
• Reduced range of motion
• Whether you had surgery
• Nerve damage, numbness, or weakness
• Ongoing pain and limitations

Many doctors use the American Medical Association's Guides to the Evaluation of Permanent Impairment to calculate ratings. Even a successful surgery can leave a permanent impairment. After a shoulder surgery, for example, you may not be able to lift overhead or carry as much weight as before.

Impairment and disability are different. Your impairment rating is a medical opinion about lost function. Your disability is a legal decision about how the injury affects you, including your ability to work. You can be impaired without being unable to work, and two people with the same rating can receive different disability awards.

South Carolina Workers' Comp Body Part Chart

South Carolina law assigns a set number of weeks of benefits to specific body parts. The chart below comes from S.C. Code Section 42-9-30. Each week is paid at your weekly compensation rate, which is 66 2/3 percent of your average weekly wage.

A few things to know about the chart:

• Partial loss is paid proportionally. A 30 percent loss of use of a hand is worth 30 percent of 185 weeks.
• Losing part of a finger or toe counts. Losing the first segment of a finger or toe is treated as half of that finger or toe. Losing more than one segment counts as the whole finger or toe.
• Body parts not on the chart can still be compensated, based on their relationship to the body as a whole, up to 500 weeks.
• Serious scarring on areas normally exposed at work, and serious burn or keloid scars anywhere on the body, can add up to 50 weeks of benefits. Here's more on compensation for scars.

How to Calculate Your Impairment Rating Payout

For a single scheduled body part, a simple way to estimate benefits is:

Disability or loss-of-use percentage x weeks for that body part x weekly compensation rate = estimated permanent disability benefits

A doctor's impairment rating is important evidence, but it does not necessarily determine the final disability percentage. The Workers' Compensation Commission may assign a different disability or loss-of-use percentage based on the evidence.

Here's a simplified example using a 20 percent disability or loss-of-use rating for a worker who earned $900 a week before the injury:

1. Weekly compensation rate: $900 x 66 2/3% = $600
2. Rating: 20 percent to the arm
3. Weeks: 20% x 220 weeks = 44 weeks
4. Benefits: 44 weeks x $600 = $26,400

Which body part the rating applies to makes a big difference. If that same 20 percent disability or loss-of-use percentage applied to the shoulder instead of the arm, it would be 20 percent of 300 weeks, or 60 weeks, which comes to $36,000. Whether a doctor rates an injury to the arm or the shoulder is often worth thousands of dollars, and it's one of the first things we look at.

Your weekly rate is also capped at a maximum set each year based on South Carolina's average weekly wage, so high earners may receive less than two-thirds of their pay. This formula is only a starting point. Your actual case value depends on the full picture. Here's more on how much a workers' comp case is worth.

What Is a Good Impairment Rating in a South Carolina Workers' Comp Case?

There's no single "good" rating. The best rating is one that accurately reflects your injury. Generally, a higher disability or loss-of-use percentage can result in higher benefits, but the value depends on the body part, the type of injury, your compensation rate, and the evidence in your case.

What matters most is whether your rating is accurate and complete. Ratings are often too low when:

• The doctor rated only one body part when the injury affects more than one
• Ongoing pain, weakness, or nerve symptoms weren't fully considered
• The rating was assigned to the arm when the injury involves the shoulder, or to a finger when it involves the hand
• The doctor didn't perform strength and range of motion testing
• You reached MMI before your treatment was really finished

What Happens When Your Rating Is 50% or Higher?

For most body parts, a 50 percent rating simply means 50 percent of the scheduled weeks. The back is different. If you have a 50 percent or greater loss of use of your back, South Carolina law presumes you are totally and permanently disabled, and benefits can extend up to 500 weeks. The employer or insurance carrier may present evidence to rebut that presumption, which is one reason back injury ratings are so often disputed. Here's more on back injuries and workers' comp.

Other situations can also qualify as total and permanent disability, including the loss, or loss of use, of both hands, arms, shoulders, feet, legs, hips, or eyes, or any two of them. Workers who are determined to be totally and permanently disabled because of paraplegia, quadriplegia, or physical brain damage are not subject to the ordinary 500-week limitation and may receive lifetime benefits. Here's more on brain injuries and workers' comp.

What If I Disagree With My Impairment Rating?

You have options. The rating from the insurance company's doctor is one piece of evidence, not the final word.

• Don't sign anything yet. Talk with a workers' comp lawyer before agreeing to a rating, a return-to-work plan, or a settlement.
• Consider another medical opinion. Depending on the circumstances, an independent medical evaluation from another qualified doctor may provide additional evidence about your impairment. Here's more on whose side the workers' comp doctor is on.
• Let the Commission decide. If you and the insurance company cannot agree, a commissioner can consider the medical evidence and other relevant evidence and determine the extent of your disability or loss of use. The Commission is not required to adopt a doctor's impairment rating as the final disability rating.
• Account for future medical care. Your rating doesn't cover the treatment you may need later. Learn about workers' comp and future medical treatment.

How Your Rating Affects Your Settlement in South Carolina

Settlement discussions often take place after you reach MMI, once the permanent effects of the injury are better understood. Your impairment rating is the starting point for negotiations, but a fair settlement also accounts for future medical needs, your ability to return to your job, and the risk to both sides of going to a hearing. Here's more on your settlement options in a South Carolina workers' comp case.

If your injury was caused by someone other than your employer, like a negligent driver, contractor, or equipment manufacturer, you may also have a third-party injury claim. Unlike workers' comp, a third-party claim can include pain and suffering, and it can be worth significantly more.

Talk With a South Carolina Workers' Comp Lawyer

An impairment rating can shape your benefits for years, and it's much easier to get it right before your case settles than to fix it after. Our team reviews your medical records and rating, makes sure every injured body part is accounted for, and pushes for the full benefits the law provides. Attorney fees in South Carolina workers' compensation cases are subject to approval by the Workers' Compensation Commission. At our firm, you do not owe attorney fees or case costs unless we recover money for you.

Call our office for a free consultation at 803-790-2800, or learn more about our work as a Columbia workers' compensation lawyer and Myrtle Beach workers' compensation lawyer.

Frequently Asked Questions About SC Workers' Comp Impairment Ratings