Why Ratings of Disability Matter for Settlement Value
In California workers’ compensation, your permanent disability rating is the most accurate way to turn your physical loss into a dollar amount. It’s not just a medical number; it directly affects how much money insurance companies have to pay you.
Most injured workers think that disability ratings are set, objective numbers. They think that if a doctor says they are “disabled,” the system will automatically send them a fair check. This is a dangerous misunderstanding. The truth is that deciding if someone is permanently disabled is a complicated process that involves both medical science and complicated math. If you’re dealing with multiple injuries and want to understand your rating options, a workers’ compensation attorney can help you navigate this complex process.
The method used to combine multiple injuries—specifically, whether to “combine” ratings using a regressive formula or “add” them together—can change the final amount of money by tens of thousands of dollars. The difference can be hundreds of thousands of dollars in cases of catastrophic injury.
The “hidden math” of the Combined Values Chart is what makes these two amounts of money so different. This legal tool systematically combines multiple disability ratings, effectively removing parts of workers’ disability and saving the insurance industry millions of dollars every year. The landmark 2024 case Vigil v. County of Kern, on the other hand, changed everything. It gave injured workers strong legal tools to fight rating compression.
How Permanent Disability Ratings Work
What a Rating Means
In California, a permanent disability rating means that your future earning potential is lower than that of your peers who are not injured. The doctor uses the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, to give the person a Whole Person Impairment percentage. This is the first step in the process.
But this “raw” medical number is only the beginning. California law makes changes to the law that turn this medical finding into a legal disability rating. Your money award is based on the final permanent disability rating, not the doctor’s first percentage.
The Factors That Change
The 1.4 modifier takes into account the doctor’s loss of future earning potential by multiplying the impairment percentage by 1.4. The rating goes up or down based on how disabling the injury is for your job. For example, a back injury is very bad for a bricklayer but not so bad for a desk worker. Finally, your age at the time of the injury matters. Older workers get higher ratings because it is harder for them to recover and find work again.
Why ratings lead to settlements
A common myth is that the value of a case is related to the cost of medical care. Carriers pay for medical care, but that money goes to hospitals and doctors, not you. The “new money” in your settlement check comes mostly from payments for permanent disability.
The relationship between the percentage of ratings and the number of weeks of payments is not linear; it gets stronger over time. A 1% rating pays for three weeks, while a 99% rating pays for almost 900 weeks. Once a rating reaches 70%, workers are eligible for a Life Pension, which is a weekly payment for the rest of their lives. A 69% rating means no Life Pension, while a 70% rating means a Life Pension. The difference can be worth hundreds of thousands of dollars over a lifetime.
The Combined Values Chart: Math You Didn’t Know
How the Chart Makes Value Smaller
When workers hurt more than one part of their body, insurance companies use the Combined Values Chart to add up the ratings. It works on the idea that people can’t be more than 100% disabled. The chart uses a non-linear formula that keeps ratings from going over 100%, but it also greatly lowers case value.
The formula is A + B(1 – A) = Combined Value, where A is the higher disability rating and B is the lower rating.
An Example from Real Life
Think about a worker who has two different injuries: a 30% injury to their lower back and a 20% injury to their knee.
Using the additive method (simple addition), 30% + 20% = 50% permanent disability. This adds up to $116,000 at 2025 rates of $290 per week for 400 weeks.
Using the formula, 0.30 + 0.20(1 – 0.30) = 44% permanent disability. This is the Combined Values Chart method. This comes to $66,410 for 229 weeks at $290 per week.
The lost value: If the insurance company strictly follows the chart, they will save $49,590 and you will lose that amount. This compression can cost workers hundreds of thousands of dollars when the ratings are close to the Life Pension threshold.
The Vigil v. County of Kern ruling
The Case’s Background
The Workers’ Compensation Appeals Board made its en banc decision in Vigil v. County of Kern on June 10, 2024. This changed the law in a big way. The case was about Sammy Vigil, a maintenance painter who hurt his back and both hips at work, which required him to have hip replacement surgery on both hips.
The Qualified Medical Evaluator said that each hip was 15% impaired and the lumbar spine was 7% impaired. The doctor said during the deposition that the hip problems should be added instead of combined because “somebody with limitations due to both hips is going to have significantly more limitations than if somebody had one normal hip.”
What the Court Said
The Appeals Board said that the Combined Values Chart is “prima facie evidence” (assumed to be correct), but it can be challenged. The decision set up a two-part test for when it is okay to add ratings:
No Overlap in Activities of Daily Living: The applicant gives a lot of medical evidence that the effects of injuries on ADLs do not overlap. If Injury A affects ADLs X, Y, and Z, and Injury B affects ADLs A, B, and C, then the two injuries do not affect the same ADLs, and the ratings should be added together.
Synergistic Overlap: There is some overlap in ADLs, but the injuries work together to make the disability worse than what the chart would show. For example, if both legs are injured and the compensatory limb is lost.
What Vigil Did
Vigil clearly says that the Combined Values Chart should not be used mechanically or automatically. It says that the goal of the rating system is to be accurate, not to follow a chart that might not show how disabled someone is. But Vigil doesn’t let you add all ratings for free. The Board made it clear that doctors need to give “reasoned analysis” that explains exactly how ADLs do or don’t interact.
The Difference Between Adding and Combining
Comparison Side by Side
Think of a worker who has three different injuries: 20% to the lumbar spine, 15% to the left shoulder, and 10% to the right knee.
First, add 20% and 15% together to get 32%. This is the Combined Values Chart method. Then add 32% and 10% together to get a final score of 39%. This comes to 194 weeks of payments at 2025 rates, which is $56,260.
Vigil additive method: If the lawyer can show that these injuries affect different ADLs (for example, shoulder affects reaching, knee affects walking, and back affects sitting), the ratings are simply added together: 20% + 15% + 10% = 45% final rating. This comes to 236 weeks of payments, which adds up to $68,440.
The difference is that the additive method gives you an extra $12,180, which is a 21% increase in value in this example.
The Multiplier for Life Pensions
In cases of severe injury, the difference gets much bigger much faster. Think about a worker who has 40% of their back hurt and 35% of their mind hurt.
When you add 40% and 35%, you get 61%. Pay out about $104,182. No Life Pension.
Added: 40% and 35% make 75%. Pay out about $148,842 in base compensation and a weekly Life Pension for the rest of the worker’s life. This pension could be worth an extra $150,000 to $400,000 over the course of a 45-year-old worker’s life.
Attorneys don’t just get more money for settlements when they change the math from combining to adding; they also open up a whole new level of lifetime benefits.
When to Use Additive Ratings
Different Parts of the Body
The Combined Values Chart’s idea of “overlapping disability” doesn’t work if injuries are anatomically and functionally different. For instance, a worker gets a crush injury to the foot (which makes it hard to walk) and a chemical burn to the face (which changes how they look and how they feel). The injury to the foot affects how you walk, and the injury to the face affects how you interact with other people. There is no overlap, and putting these ratings together makes two completely separate disabilities seem less valuable.
Injuries on both sides
When workers hurt both hands, both knees, or both shoulders, the disability is synergistic. The body uses the other limb to make up for the loss. The left hand does things if the right hand is hurt. If both are hurt, workers lose their “backup.” The disability isn’t just doubled; it’s worse because the way to make up for it is gone.
The Need for Proof
Vigil sets the rules, but the results are based on the evidence. Just because someone has more than one injury doesn’t mean they will add. Your lawyer needs to show, with strong medical evidence, that ADLs are different or work together. If the medical report doesn’t say much about ADLs or is unclear, the judge will use the Combined Values Chart by default.
Questions that are often asked
Does Vigil mean that all injuries must be added together instead of combined?
No. Vigil does not require addition in all cases. The Combined Values Chart is still the default. To switch to addition, applicants must show with strong medical evidence that there is either no overlap in ADLs or that overlap makes disability worse. The chart applies if the evidence is neutral or doesn’t say anything.
Can my rating go up after it’s been given?
Yes, but only up to a point. You can challenge a rating if you haven’t settled your case yet. An attorney can depose the doctor to get more evidence for Vigil or ask for a second report. But if a judge has already made a final decision and award, or if you’ve signed a settlement, it’s usually too late to apply Vigil.
What types of cases get the most out of additive ratings?
The most significant value increases occur in cases involving orthopedic and psychiatric injuries (such as back pain combined with a sleep disorder), bilateral extremities (injuries to knees, wrists, hips, or shoulders on both sides), and high-value cases approaching the 70% Life Pension threshold. Pushing a 65% combined rating up to a 75% additive rating makes a huge difference in money because of the Life Pension.
Check Your Rating
If you got a permanent disability rating that doesn’t seem to take into account how complicated your injuries are, or if you’re about to settle with the insurance company and more than one body part is involved, don’t take their calculation as final. The difference between “adding” and “combining” could change your financial future.
ODG Law Group is an expert at breaking down complicated rating reports and using the most recent case law, like Vigil, to get the best settlement amounts. We encourage you to set up a full review of your permanent disability ratings. We don’t settle cases quickly; instead, we focus on getting the most value over the long term. This means that every dollar of compensation and every percentage point of disability is taken into account.
If your case isn’t over yet, it might not be too late to challenge the way the ratings were done. A permanent disability attorney can review your case and help you maximize your settlement value. Please get in touch with us right away to talk about your options.
Call ODG Law Group today to get a strategic look at your disability rating. You can call 818-230-2428 or go to www.odglawgroup.com.
