Permanent and Total Disability Benefits Under Workers' Compensation Laws

If you have suffered an injury on the job, you may be entitled to workers’ compensation benefits. Each state has its own workers’ compensation system, which is designed to provide injured employees with compensation for their medical expenses and lost wages. In general, compensation for a worker’s injuries, also called benefits, will be paid through the system regardless of who is at fault for the accident.

The workers’ compensation system operates independently from the judicial system, and it imposes its own series of complex rules and requirements. In exchange for benefits, the worker gives up the right to sue the employer for the injuries that he or she sustained. This is typically referred to as the “exhaustion of remedies” doctrine. A court may review certain decisions from a workers’ compensation judge, but only after the injured employee has exhausted the remedies made available to him or her through the workers’ compensation system. There are some exceptions to this requirement, such as when the injury occurred as a result of the employer’s recklessness.

Eligibility

In order to receive benefits, an injured worker must prove that he or she has suffered injuries or disabilities. Virtually every state characterizes workers’ injuries according to certain classes. For example, the workers’ compensation system classifies injuries according to whether they are partial, total, temporary, or permanent. The most severe injury that an employee can suffer is a permanent and total disability. This occurs where the worker’s wage-earning ability is completely and permanently lost. Upon qualifying for permanent and total disability benefits, the worker is eligible to receive disability benefit payments on a regular basis for the remainder of the employee’s life. In some jurisdictions, the employee can receive these disability benefits in the form of a one-time lump sum payment. The state Office of Worker’s Compensation must typically approve the lump sum payment before it can occur. Additionally, any permanent and substantial disfigurement to a worker’s face, neck, or head may qualify the worker to receive a compensation benefit of up to $20,000.

Many healthcare providers are familiar with the workers’ compensation system and can evaluate whether a worker qualifies for permanent or total disability. A judge will typically require a worker to provide sufficient evidence from both the worker’s treating physician and an appointed physician regarding the nature and extent of the injuries. Some states have enacted a list of serious and catastrophic injuries that are presumed to result in a permanent and total disability. This does not automatically entitle the employee to permanent and total disability benefits, but it tends to work to the employee’s advantage.

Characteristics of Permanent and Total Disability

Based on the history of workers’ compensation claims resulting in determinations of permanent and total disability, there are some common characteristics among the victims. First, most permanent and total disability victims have a history of engaging in arduous physical labor, such as construction work. Secondly, permanent and total disability sufferers generally lack formal education and the ability to read. Without these skills, a worker is highly less likely to obtain employment in a non-physical capacity. Finally, the types of injuries that permanent and total disability sufferers experience typically include serious head traumas or spinal injuries that require extensive surgery. A history of mental illness is also common among permanent and total disability sufferers, since it indicates the potential serious difficulties they would experience while attempting to function in an office setting.

Last reviewed October 2024