N.C. Industrial Commission
Medical Billing Section
4337 Mail Service Center
Raleigh, NC 27699-4337

Last Updated: 5 February 2009

 

Section 1: Evaluation of Permanent Physical Impairment

DISTINCTION BETWEEN EVALUATION OF PERMANENT DISABILITY AND PERMANENT PHYSICAL IMPAIRMENT

The Disability Committee of the American Medical Association (AMA) has pointed out that the evaluation of permanent disability is twofold1:

  1. The medical evaluation of the permanent physical impairment.
  2. The rating of the disability according to the administrative bodies.

The AMA Guide further explains that there should be a distinction between the terms, "permanent disability" and "physical impairment," defined as follows:

  1. "Permanent disability is not a purely medical condition. A patient is ‘permanently disabled’ if ‘under a permanent disability’ when his actual or presumed ability to engage in gainful activity is reduced or absent because of ‘impairment’ and no fundamental or marked change in the future can be expected."
  2. "Physical impairment is a purely medical condition. Permanent physical impairment is any anatomical or functional abnormality or loss after maximum medical rehabilitation has been achieved and which abnormality or loss the physician considers stable or non-progressive at the time the evaluation is made."
  3. "The evaluation rating of ‘permanent disability’ is an administrative, not a medical responsibility and function."

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1AMA Guide to the Evaluation of Permanent Impairment, American Medical Association, February. 1989.

DEFINITION OF DISABILITY

According to Webster’s Dictionary, disability is defined as:

  1. "State of being disabled; absence of competent physical, intellectual, or moral power, fitness, or the like; also an instance of such lack."
  2. "Legal incapacity, incompetence, or disqualification."

Medically, disability is physical impairment and inability to perform physical functions normally.

Legally, disability is permanent injury to the body for which the person should or should not be compensated.

Under the statutes of workers’ compensation, disability may be divided into three periods—which are:

  1. Temporary total disability is that period in which the injured person is totally unable to work. During this time he receives medical treatment.
  2. Temporary partial disability is that period when recovery has reached the stage of improvement so that the person may begin some kinds of gainful employment.
  3. Permanent disability applies to permanent damage or to loss of use of some part of the body after the stage of maximum improvement from medical treatment has been reached and the condition is stationary.