When you’ve been hurt on the job, recovering physically is only part of the challenge. Once your treatment stabilizes, another question often arises: how much has your injury permanently affected your ability to work? In Massachusetts, the answer to that question often depends on something called an impairment rating assessment.

This evaluation plays a key role in the workers’ compensation process. It measures the degree of lasting impairment caused by a work-related injury and helps determine what level of benefits you may receive moving forward. Many injured workers don’t realize that reaching the point of “maximum medical improvement” (MMI) doesn’t end their case—it simply shifts the focus from recovery to the long-term impact of their condition.

Understanding how impairment ratings work, who performs them, and how they influence compensation is key to protecting your rights. Below, we break down the process in practical terms, explain what to expect, and discuss how a Massachusetts workers’ comp attorney can make sure your rating is accurate and fair.

What a Workers' Comp Impairment Rating Actually Means

Under Massachusetts General Laws Chapter 152, workers’ compensation provides benefits for employees injured or made ill by their jobs. These benefits cover medical expenses and lost wages, but when an injury causes a lasting physical limitation, an additional layer of benefits may apply—those based on permanent impairment.

An impairment rating is a percentage that represents how much permanent damage your injury has caused. It’s not about your job title or your earning capacity; it’s about the physical loss of function itself. The higher the percentage, the greater the long-term impairment—and the larger the potential compensation.

The rating is especially important in cases involving permanent partial disability (PPD) or permanent total disability (PTD), where the impact of the injury extends well beyond the initial treatment period.

In Massachusetts, Who Conducts the Impairment Rating Assessment?

Not just any doctor can perform an impairment evaluation. The assessment must be completed by a physician trained to use the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment—a standardized system used across the country. The AMA Guides provide detailed criteria for measuring loss of motion, strength, sensation, or other physical functions.

In Massachusetts, the Department of Industrial Accidents (DIA) may appoint an impartial physician under Section 11A of the Massachusetts Workers’ Compensation Act when there’s a dispute about the extent of a worker’s medical condition or level of disability. This impartial physician reviews medical records, examines the worker, and provides an official impairment rating. The DIA’s impartial reports carry significant weight, though workers can also submit opinions from their own treating physicians for comparison.

An experienced workers’ comp impairment rating attorney in Massachusetts can coordinate these evaluations, ensure the documentation is complete, and help address discrepancies between medical opinions.

Timing: When the Rating Takes Place

Impairment ratings typically occur once the worker has reached maximum medical improvement (MMI)—the point when further treatment isn’t expected to significantly improve the condition. MMI doesn’t mean full recovery; it simply means your healing has plateaued.

At this stage, the evaluating physician performs a physical exam, reviews test results, and measures how your injury affects your daily activities. For example, a back injury may limit bending or lifting, while a hand injury may reduce grip strength or dexterity. The doctor then assigns a percentage value representing your degree of permanent impairment.

That number may seem abstract, but it carries real financial implications. It’s the foundation for calculating certain categories of long-term benefits and can heavily influence the outcome of a potential settlement.

How Impairment Ratings Affect Workers’ Comp Benefits in Massachusetts

The impairment rating feeds directly into the Massachusetts workers’ compensation benefit structure. Depending on your medical outcome, you may qualify for one of the following benefit categories:

1. Temporary Total Incapacity (M.G.L. c. 152, § 34)

If you’re unable to work at all for a period of time, you can receive 60% of your average weekly wage (subject to state limits) until you’re able to return or reach MMI.

2. Temporary Partial Incapacity (M.G.L. c. 152, § 35)

If you return to work but earn less due to your injury, you may receive 60% of the difference between your pre- and post-injury wages.

3. Permanent and Total Incapacity (M.G.L. c. 152, § 34A)

If your injury prevents you from performing any substantial work in the future, you may qualify for two-thirds of your average weekly wage for life, plus continued medical coverage.

A higher impairment percentage generally supports greater compensation. For example, a mild shoulder strain may produce a 5% impairment rating, while a severe spinal injury could lead to a 40% or higher rating. That difference can significantly impact both ongoing benefits and potential lump-sum settlements.

Understanding the Rating Scale in Massachusetts

The AMA Guides, Fifth Edition, form the backbone of the impairment rating guide used in Massachusetts. The scale is designed to ensure consistency between doctors and across injury types. Ratings account for pain, range of motion, loss of strength, and other measurable factors.

Examples include:

• Spinal injuries: Based on motion limitations, neurological involvement, and pain levels.
• Limb injuries: Measured by reduced strength, flexibility, or dexterity.
• Sensory loss: Determined by comparing the percentage of lost hearing, vision, or sensation to total function.

While the system strives for objectivity, there’s still room for interpretation—especially in complex injuries or those involving multiple body parts. That’s one reason disputes over impairment ratings are so common.

Disputing or Reviewing an Impairment Rating

It’s not unusual for the worker’s doctor and the insurance company’s doctor to reach very different conclusions. If you believe your rating doesn’t reflect the true extent of your limitations, you have the right to challenge it.

Your attorney can:

• Request a second or independent medical evaluation.
• Submit evidence from your treating physicians.
• Appeal to the Department of Industrial Accidents Reviewing Board for further review.

These steps can make a real difference in the outcome of your claim. A fair rating ensures you’re compensated for the full scope of your injury—not just what the insurer prefers to recognize.

How Ratings Affect MA Workers’ Comp Settlements

Impairment ratings are also a key factor in workers’ comp settlements. Insurers often use the percentage to estimate the potential value of future payments, then offer a lump-sum amount based on that projection. A higher impairment rating usually means a higher settlement value.

However, once you agree to a settlement, you may give up certain rights to future benefits. Before signing, it’s essential to review the numbers carefully with a lawyer who understands workers’ comp settlement impairment ratings in Massachusetts. An attorney can evaluate whether the proposed amount truly reflects your condition and financial needs.

Common Pitfalls and How to Avoid Them

Injured workers often make small mistakes that have big consequences for their impairment rating. Here are a few to watch for:

• Going into the exam without bringing complete medical records.
• Downplaying symptoms during the evaluation.
• Failing to mention secondary effects, like chronic pain or reduced stamina.
• Relying solely on the insurer’s chosen doctor without obtaining an independent opinion.

Preparation matters. Keeping thorough records, being candid about your symptoms, and consulting an attorney beforehand can all help ensure an accurate and fair assessment.

Preparing for Your Impairment Evaluation

Treat your impairment exam as a formal part of your claim—not just another doctor visit. Be honest, detailed, and specific about how the injury affects your daily life and work activities. Describe any pain, weakness, or limitations clearly. Bring documentation of surgeries, physical therapy, or diagnostic results to support your case.

If you’re unsure what to expect, your lawyer can walk you through the process, explain your rights, and ensure the evaluation follows the proper legal and medical procedures.

Call Brandon J. Broderick For Legal Help

If you’re facing an impairment rating assessment in Massachusetts, you don’t have to navigate the process alone. At Brandon J. Broderick, Attorney at Law, our legal team helps injured workers understand their rights, prepare for medical evaluations, and pursue the benefits they deserve under Massachusetts law.

Contact us today to schedule a consultation and learn how we can help you secure the full benefits you’re entitled to after a workplace injury.