Permanent Disability Rating Too Low? What Workers Should Check

The permanent disability rating arrives as a percentage. It may look too low compared with the injury, surgery, restrictions, or daily problems you live with.

Do not begin by arguing that the percentage feels unfair. Begin by finding out what document you received, which medical report it rated, which inputs were used, and what kind of disagreement you actually have.

A low number can come from very different problems:

• the rating used the wrong occupation, age, injury date, impairment value, or calculation;
• the medical report left out an issue or did not explain it completely;
• you disagree with the doctor's medical opinion about impairment or apportionment;
• the percentage is being confused with PD payments, an award, or a proposed settlement.

Those problems do not use one universal objection form. The correct response may depend on representation, the type of rating, the medical evaluator, the date you received the document, and whether the claim is already litigated.

This article provides general information, not legal advice or a rating calculation. Do not use it to calculate a deadline, permanent disability percentage, weekly rate, award, or settlement. Review the actual rating, medical report, notices, service dates, representation status, and procedural history promptly.

First Confirm What Rating Document You Received

The California Division of Workers' Compensation says its Disability Evaluation Unit, or DEU, prepares three types of permanent disability ratings:

• Formal ratings, requested by a workers' compensation judge;
• Consultative ratings, prepared in litigated cases at the request of an attorney or DWC Information and Assistance officer; and
• Summary ratings, prepared in non-litigated cases at the request of a claims administrator or injured worker.

Do not call every percentage sheet a “DEU summary rating.” The document may instead be:

• an estimate prepared by the claims administrator;
• a rating string attached to settlement correspondence;
• a formal or consultative DEU rating;
• a judge's finding or award;
• a medical report stating impairment but not the final PD rating; or
• a benefit notice showing payment calculations.

Read the heading, issuer, report date, claim number, injury date, and evaluator name. Save every page and the envelope, email, portal notice, or other record showing when you actually received it.

The document's identity matters because DEU Form 103 is a narrow request available when the employee is unrepresented. In that setting, either the employee or the employer may ask the Administrative Director to reconsider a DEU rating under Labor Code section 4061(g). The official form states that this procedure applies only to injuries occurring on or after January 1, 1991. It is not a universal appeal from every rating, medical opinion, award, or settlement.

A Rating Is Not the Same as the Doctor's Medical Opinion

The medical report supplies the findings that become rating inputs. The rating applies the applicable schedule and rules to those findings.

That creates two separate layers:

1. Medical layer: impairment, body parts, diagnoses, restrictions, causation, MMI/P&S status, future care, and apportionment.
2. Rating layer: how the medical findings are converted, adjusted, combined, and expressed as a permanent disability percentage.

Suppose the rating accurately copies the impairment and apportionment stated by the QME, but you believe the QME understated the impairment or blamed too much disability on a prior condition. That is not necessarily a rating-calculation error. It may be a medical-opinion or medical-report dispute.

Now suppose the doctor assigned an impairment value to the right shoulder, but the rating copied a different number or omitted the shoulder. That may raise a rating-input or calculation question.

WCLG's separate guide on QME report errors explains why factual errors, incomplete reports, and medical disagreements require different procedures.

Build a Line-by-Line Rating Audit

Do not write “the rating is wrong” across the top and stop there. Make the issue reviewable.

Create a working chart with these columns:

1. Rating line: Identify the exact line, code, abbreviation, or percentage.
2. Value shown: Copy it exactly.
3. Source-report page: Find where the medical report supplies that input.
4. Source value: Record what the report actually says.
5. Possible issue type: Identity, occupation, age, impairment, omitted issue, apportionment, calculation, medical opinion, or payment.
6. Supporting record: Job description, work history, medical page, prior award, benefit notice, or another existing document.
7. Receipt date: Record when the rating or notice arrived and how you can prove it.
8. Deadline to review: Flag it for immediate review without calculating it from a blog article.

Keep the original unchanged. Use a separate copy for highlights and notes.

Check the Worker, Claim, Injury Date, and Medical Report

Start with basic identity fields. Small administrative mismatches can point to a larger problem.

Compare:

• worker name;
• employer;
• claim number;
• DEU or EAMS number;
• specific injury date or cumulative-trauma period;
• body parts or conditions;
• QME, AME, or primary treating physician;
• medical-report date;
• date the worker reached MMI or permanent and stationary status;
• whether the rating identifies the report you actually received.

Do not publish a completed rating sheet or Form 103 online. Those documents may contain a Social Security number, claim number, EAMS/DEU identifier, medical information, address, and other private data.

Check the Occupation Against the Work Actually Performed

DWC says a disability rating is based in part on the type of work the employee performed when injured. Labor Code section 4660.1 also identifies occupation as a rating factor for injuries on or after January 1, 2013.

The payroll job title may not describe the physical job.

A worker called a “technician” may spend each shift lifting equipment, climbing ladders, kneeling, reaching overhead, or driving. A “supervisor” may still load trucks, move patients, cook, clean, or operate machinery.

Preserve:

• written job description;
• hiring paperwork;
• schedules and assignments;
• physical-demand analysis, if one exists;
• training records;
• lawful photographs of tools or workstations;
• witness names;
• a factual list of lifting, carrying, standing, walking, bending, reaching, keyboard, vibration, driving, or repetitive duties;
• how often and how long those duties were performed.

Preserve only records and photographs you may lawfully possess. Do not take, upload, or publish restricted employer records, patient or customer information, coworker personal information, security credentials, or trade-secret material.

Do not exaggerate the job to chase a higher modifier. Describe the actual work accurately enough that someone can compare it with the occupation used in the rating.

Check Age and Injury-Date Rules

DWC's permanent disability page explains that age and occupation are part of the rating formula. The injury date also matters because California's rating rules have changed over time.

For injuries on or after January 1, 2013, Labor Code section 4660.1 directs that the permanent-disability percentage account for the nature of the physical injury or disfigurement, the worker's occupation, and age at injury. The statute incorporates impairment descriptions and measurements from the AMA Guides, Fifth Edition, multiplies whole-person impairment by an adjustment factor of 1.4, and applies age and occupational modifiers.

That does not mean a public article can reconstruct every rating. Check:

• date of birth shown in the claim file;
• age used at the date of injury;
• specific injury date or cumulative-trauma period;
• rating schedule identified;
• whether the document applies a rule that matches the injury date.

Do not assume that a formula described for a recent injury applies to an older claim.

Compare Every Impairment and Body-Part Entry

Read the physician's permanent-and-stationary or MMI report beside the rating.

For each body part or condition, identify:

• diagnosis;
• impairment method;
• whole-person-impairment value, if stated;
• table, figure, or method cited by the physician;
• work restrictions;
• future medical care;
• causation opinion;
• apportionment opinion;
• whether the physician said an issue could not yet be rated;
• whether multiple impairments were combined or adjusted.

Do not add percentages yourself. Multiple impairments are not necessarily combined by ordinary addition, and the medical and rating rules can be technical.

If a report leaves out a body part or does not address an issue, the rating unit may not have medical findings to invent. That may be an incomplete-report problem, not arithmetic.

If the report itself contains a wrong date, work history, missing record, or incomplete analysis, preserve the error and use the procedure that fits the evaluator, representation status, and claim posture. Do not call or message a QME or AME to argue about the substance of the report.

Apportionment Can Lower the Industrial Rating

Labor Code section 4663 makes apportionment of permanent disability causation-based. Subject to the statute's specified exceptions, a physician reporting on permanent disability must address causation, and a complete report must state the approximate percentage caused directly by the industrial injury and the approximate percentage caused by other factors before or after that injury, including prior industrial injuries. If the physician cannot make the determination, the report must state the specific reasons.

Section 4664 limits employer liability to the percentage of permanent disability directly caused by the industrial injury. It also provides that a prior permanent-disability award conclusively establishes the existence of that prior disability at the time of a later industrial injury and imposes lifetime award limits by listed body region.

A lower rating may therefore involve questions such as:

• Did the rating copy the physician's apportionment percentage correctly?
• Did the physician explain the causes and percentages?
• Does the report identify the evidence supporting the opinion?
• Is a prior award being considered?
• Does the disagreement concern the rating's math or the doctor's medical reasoning?

A calculator cannot resolve a medical-causation dispute. Preserve the current report, prior medical records, prior awards, work history, injury history, and the exact rating calculation. Do not hide a previous injury or condition; accuracy matters.

Representation Changes the Statutory Route

Labor Code section 4061(b) directs represented parties disputing a treating-physician determination to the medical-evaluation procedure in section 4062.2, while section 4061(c) directs unrepresented cases to section 4062.1. Section 4061(d)'s narrow factual-correction request involving a QME report is also separate from section 4061(g)'s reconsideration of a rating.

Do not use Form 103 as a substitute for those procedures. Representation, evaluator type, service dates, prior QME or AME history, litigation status, and the document being disputed can change the route.

When DEU Form 103 May Apply

DWC's Information and Assistance Guide 3 and DEU Form 103 describe a request for reconsideration of a summary rating by the Administrative Director.

The form states that when the employee is unrepresented, either that employee or the employer may request reconsideration under Labor Code section 4061(g). It also states that this procedure applies only to injuries occurring on or after January 1, 1991. The official materials identify four grounds:

1. the QME or primary treating physician failed to address all issues;
2. the QME or primary treating physician failed to address issues completely;
3. the QME or primary treating physician failed to follow required evaluation procedures; or
4. the rating was incorrectly calculated.

The official guide says the request must be submitted within 30 days of receiving the rating. It calls for the summary rating, medical report, supporting information, and proof of service, with a copy sent to the insurance company.

That deadline is serious, but this article will not calculate it. Confirm:

• whether the document is actually a DEU summary rating;
• whether the worker is unrepresented;
• when and how the rating was received;
• which stated ground may apply;
• which supporting documents belong with the request;
• where and how the current form must be submitted and served.

A worker should not select “incorrectly calculated” merely because the percentage seems low. The explanation should identify the claimed mismatch or error precisely.

Disagreement With the Doctor Is a Different Problem

DWC Guide 3 expressly says that disagreeing with the QME's or treating doctor's conclusion, by itself, is not a reason to object to the summary rating through Form 103.

Examples of medical disagreements include:

• the doctor assigned too little impairment;
• the doctor found the worker MMI/P&S too soon;
• the doctor imposed the wrong restrictions;
• the doctor reached an unsupported medical opinion about causation or apportionment.

Do not confuse that disagreement with an omitted or incomplete issue. A body part, diagnosis, future-care question, apportionment analysis, or other required issue that was not addressed, or was addressed incompletely, may implicate one of Form 103's first two grounds if the worker, rating, injury date, and procedure otherwise qualify. A lack of medical explanation should be reviewed as a possible incomplete-report issue rather than automatically labeled a disagreement.

The possible next step may involve a report-completion request, QME or AME procedure, objection, deposition, litigation, or another response depending on the actual file. Representation changes the route. If you have an attorney, route the issue through that attorney. If you are unrepresented, contact a DWC Information and Assistance officer or qualified workers' compensation counsel promptly before contacting an evaluator or filing a form.

A Rating Percentage Is Not the Payment Ledger or Settlement Value

Even a correct rating percentage does not answer every money question.

Keep these records separate:

• PD rating determination;
• section 4061 benefit notice;
• PD estimate;
• PD advance checks or deposits;
• payment ledger;
• weekly rate and payment periods;
• prior credits;
• award;
• proposed stipulations;
• Compromise and Release;
• future-medical-care terms;
• return-to-work or voucher documents.

If temporary disability stopped after MMI but PD advances did not begin, read WCLG's guide on the TD-to-PD payment transition. That is a payment-timing and notice problem, not automatically a summary-rating challenge.

Do not assume a higher rating produces a specific settlement amount. Benefits, payment duration, credits, future care, employment status, prior awards, and settlement terms may all matter.

Permanent Disability Rating Review Checklist

Bring these records to a review:

• complete rating determination;
• proof of receipt date;
• QME, AME, or PTP report used;
• other treating and diagnostic records;
• DWC-1 and claim-status notices;
• injury date and cumulative-trauma allegations;
• date of birth and age used;
• job title, actual duties, and occupational-group information;
• impairment and body-part entries;
• apportionment analysis and prior-award documents;
• work restrictions and MMI/P&S findings;
• DEU Form 103 or other objection documents, if any;
• proof of service and responses;
• PD notices, estimates, advances, and payment ledger;
• proposed settlement, award, and future-care documents;
• a line-by-line issue chart.

Do not alter originals, delete unfavorable pages, or send selected records directly to an evaluator outside the applicable communication rules.

Official Sources

• DWC Disability Evaluation Unit
• DWC Information and Assistance Guide 3: How to object to your summary rating
• DWC DEU Form 103
• DWC permanent disability benefits
• California Labor Code section 4061
• California Labor Code section 4660.1
• California Labor Code section 4663
• California Labor Code section 4664

Talk to WCLG About the Actual Rating Packet

A percentage alone does not show whether the problem is the rating calculation, occupation, age, medical report, impairment opinion, apportionment, payment history, or settlement paperwork. The useful review starts with the complete packet and the date each document arrived.

Workers' Compensation Law Group helps injured workers in Downey, the Gateway Cities, Southeast Los Angeles County, and throughout Los Angeles County review permanent disability ratings, medical reports, apportionment issues, benefit notices, and payment records.

Call (562) 608-8870 or contact WCLG for a free consultation about the actual documents. A consultation does not create an attorney-client relationship unless the firm and client enter an agreement. Available benefits and options depend on the medical evidence, rating inputs, injury date, deadlines, representation, and procedural posture.