Permanent Disability, Apportionment, and the Voucher Calculation
A 55-year-old journeyman plumber has an accepted left knee injury from a fall. After treatment, the treating physician declares him permanent and stationary with a 30% whole person impairment under the AMA Guides, using the range of motion method. The physician apportions 10% to a prior non-industrial knee condition documented in 2018 records. The employee's pre-injury average weekly wage was $1,400. The employer has 80 employees and offers no modified or alternative work. The adjuster has the treating physician's report, the 2018 records, and a rating worksheet showing a 30% impairment. The employee is 55 and has no prior permanent disability awards. The adjuster must compute the permanent disability indemnity and determine voucher eligibility.
1. How should the adjuster apply the 10% apportionment, and what is the resulting permanent disability rating?
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Apportionment under Labor Code 4663 must be based on substantial medical evidence identifying the percentage of permanent disability caused by the industrial injury versus other factors. The physician apportioned 10% to the prior non-industrial knee condition, so the industrial share of the 30% whole person impairment is 20%. The adjuster applies the 20% impairment to the permanent disability rating schedule using the employee's age (55) and occupation (journeyman plumber, a heavy occupation), which produces an adjusted rating higher than the raw 20% because of the age and occupational modifiers. The adjuster should not simply subtract 10 percentage points from the final dollar figure; the correct method is to reduce the impairment before applying the schedule modifiers. The 2018 records support the apportionment, so the adjuster can rely on it, but should verify the physician's report explains how the prior condition contributes to the current disability rather than merely noting its existence.
2. Calculate the permanent disability indemnity exposure and explain the payment schedule.
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Permanent disability indemnity is paid at two-thirds of the employee's average weekly earnings, subject to the statutory minimum and maximum, and is capped by the number of weeks corresponding to the rating. With an average weekly wage of $1,400, two-thirds is $933.33 per week, which is above the statutory maximum for the injury year, so the adjuster must apply the maximum weekly rate in effect for the date of injury. The number of weeks is derived from the adjusted rating percentage under the schedule. The adjuster should multiply the capped weekly rate by the weeks for the adjusted rating to get the total, then confirm whether the amount exceeds the statutory cap on total permanent disability indemnity. Payment is made biweekly, and the adjuster should issue an advance against the final amount if the rating is not yet final, then true up. The adjuster must also account for any prior permanent disability awards, of which there are none here.
3. Is the employee entitled to a supplemental job displacement voucher, and how does the 80-employee count affect the answer?
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Yes, likely entitled. Under Labor Code 4658.5, an employee with a permanent disability rating who is not offered regular, modified, or alternative work within 60 days of the physician's permanent and stationary declaration is entitled to a supplemental job displacement voucher. The employer has 80 employees, which is above the 50-employee threshold, so the employer has an affirmative obligation to offer regular, modified, or alternative work within 60 days. Because the employer offers no modified or alternative work, the voucher obligation is triggered. The voucher amount depends on the permanent disability rating: a rating under 15% yields a lower voucher, 15% to 25% a mid-range voucher, and 26% to 49% a higher voucher, with the highest tier for ratings of 50% or more. The adjuster should confirm the adjusted rating tier, issue the voucher timely, and document the employer's no-work response.