The public, doctors, judges, and lawyers who practice before state and federal courts, workers’ compensation commissions, and Social Security hearing offices often use the words disability and impairment interchangeably.
This frequent fusion of disability and impairment is unsurprising. For example, Merriam-Webster’s Dictionary defines disability as “a physical, mental, cognitive, or developmental condition that impairs, interferes with, or limits a person’s ability to engage in certain tasks or actions or participate in typical daily activities and interactions.”
Put differently, this definition says a person is disabled if they have an impairment that limits opportunities or abilities.
But disability and impairment have different meanings under the law.
Impairment and disability are not just simple terms but complex legal concepts that determine your eligibility for workers’ compensation benefits, whether you qualify for Social Security disability (SSDI or SSI), and the viability of a lawsuit under the Americans with Disabilities Act (ADA).
Understanding how a specific court defines disability and impairment is not just theoretical, but a practical tool for asserting your legal rights and calculating a reasonable workers’ compensation settlement range. This knowledge empowers you to make informed decisions about your legal situation.
This article explains the definitions of disability and impairment in Social Security and workers’ compensation law and what evidence you must present to prove either in your case.
If you have questions about disability, impairment, or handicaps and your legal remedies, call us at (804) 251-1620 or (757) 810-5614.
We obtain financial security for auto accident victims, injured employees, and others unable to work due to injury or illness.
Let’s start with a basic definition of impairment.
Black’s Law Dictionary, an authoritative legal resource in its 11th Edition, provides a general definition of impairment: “The quality, state, or condition of being damaged, weakened, or diminished; specif., a condition in which a part of a person’s mind or body is damaged or does not work well, esp. when the condition amounts to a disability.”
Therefore, impairment is a medical issue referring to a problem with a part of the body, an organ, or one of the senses.
Now, read definitions of disability you are likely familiar with.
The Random House Dictionary of the English Language, Second Edition, defines disability as the “lack of adequate power, strength or physical or mental ability; incapacity.” This dictionary also provides alternative definitions of disability, including “a physical or mental handicap, esp. one that prevents a person from living a full, normal life or from holding a gainful job.”
Similarly, the American Medical Association (AMA) defines disability “as a decrease in, or the loss or absence of, the capacity of an individual to meet personal, social, or occupational demands, or to meet statutory or regulatory requirements because of an impairment.”
Disability, therefore, is a vocational issue that refers to functional limitations caused by impairment. These limitations may affect your work abilities or your ability to independently perform activities of daily living (ADLs).
Although the above general definitions of disability and impairment provide a foundation, these words have different meanings in legal matters.
The ADA, Social Security Act, and federal and state workers’ compensation laws introduce specific definitions of disability and impairment. These definitions not only distinguish the terms but also complicate their relationship, adding a layer of complexity to the understanding of these concepts in legal contexts.
The relationship between disability and impairment, and whether you have proof of one or both, matters because it influences what cash payments you can receive under these legal systems.
The following sections will delve into the specific definitions of impairment and disability outlined by the Social Security Administration (SSA) and workers’ comp agencies, focusing on judicial precedent (case law) in Virginia.
The difference in the meanings of impairment and disability is drastic in Social Security disability claims.
In Social Security law, impairment only refers to your physical or mental medical conditions.
Every injury, illness, or disease diagnosed is an impairment. The critical question is whether the condition is severe or not severe.
The SSA will find a medical condition a “not severe” impairment only if it is a slight abnormality with such a minimal effect on you that it should not interfere with your ability to work, regardless of age, education, or work experience.
In contrast, the SSA defines a severe impairment as any health condition significantly limiting your physical or mental ability to perform basic work activities when considering claims for SSDI or SSI.
The SSA’s regulations list examples of basic work activities:
Federal courts have said proving a medical condition that results in severe impairment “does not present a high threshold to meet.” You can prove impairment in Social Security claims through witness testimony or medical reports.
The word “disability” is a term of art in Social Security law.
The Social Security Act defines “disability” as an inability to engage in any substantial gainful activity [SGA] because of any medically determinable physical or mental impairment that you expect to last for a continuous period of not less than 12 months or result in death.
Proving disability under Social Security law involves a five-step sequential evaluation process. Establishing a severe medical impairment is just one part.
Four available workers’ comp benefits include the word “disability.”
For example, during one workers’ compensation claim, you may recover payments for:
In workers’ compensation, the definition of disability is “whether the employee is able fully to perform the duties of his pre-injury employment.”
In workers’ comp, you have “disability” if your work-related injury or occupational disease limits what you can do, and that limitation causes a reduction in your earnings.
No lost wages mean no disability.
Disability, therefore, is a vocational dispute in work injury litigation resolved by how the medical evidence answers three questions:
Generally, depending on your wage loss, you will qualify for TTD or TPD if your workers’ compensation doctor gives you written work restrictions limiting your ability to perform each task needed in your pre-injury job. The court considers you disabled because you cannot perform one or more physical, mental, or social functions that you had to do as part of your job before you suffered harm.
Although a written letter from a doctor is sufficient to obtain TTD or TPD benefits, it is insufficient to recover permanent partial or permanent total disability under workers’ comp. Instead, you must prove permanent impairment with objective evidence to get these payments.
Unless the loss of use is total, such as with an amputation injury, many state workers’ compensation systems will only pay PPD or PTD benefits if you present a numerical rating signed by a medical doctor that quantifies the impairment amount.
Currently in its Sixth Edition, the AMA Guides to the Evaluation of Permanent Impairment is the source most often used by medical doctors and other health care professionals to evaluate impairment from an occupational injury or illness.
The Guides define impairment as a significant deviation, loss, or loss of use of any body structure or body function in an individual with a health condition, disorder, or disease.
A person with medical knowledge examines you after you reach maximum medical improvement (MMI) for the work-related injury. Then, using the Guides’ criteria for your specific injury, the examiner issues a permanent impairment rating (learn more about the evaluation here). Usually this impairment evaluation occurs when you undergo a functional capacity evaluation (FCE) to decide on permanent work restrictions.
Examples of impairment include:
This permanent impairment rating controls the value of permanent partial disability benefits for scheduled body parts or whether you qualify for PTD payments for permanent and total incapacity.
Duration is another difference between impairment and disability in workers’ compensation.
Disability may be temporary or permanent.
For example, a person with a back injury may heal fully and return to work within six weeks.
This employee has a temporary disability but no impairment.
Impairment, however, is permanent damage to your body after reaching maximum medical improvement and is unlikely to improve regardless of the medical treatment provided.
You can have medical evidence of permanent impairment with no wage loss.
Similarly, you may suffer reduced earnings without permanent impairment.
You may find it easier to understand the difference between impairment and disability in workers’ compensation cases with examples.
Example #1: Same Impairment but Different Disability
Two injured employees who are the same age with the same educational background can suffer the same injury (let’s say, rotator cuff tears in the right shoulder) requiring surgery and receive the same permanent impairment rating but differ in the disability benefit award received.
Employee A is a truck driver whose job requires heavy lifting. He receives permanent restrictions on lifting over 20 pounds, which prevents him from returning to his pre-injury job. Therefore, he qualifies not only for permanent partial disability from his impairment but also for disability benefits if he stays out of work or finds a lighter job but has wage loss.
Employee B is a nurse with a sedentary job (mostly paperwork). She receives the same permanent restrictions as Employee A but can do her pre-injury job within these restrictions. Therefore, she qualifies for permanent partial disability but does not qualify for an award of wage loss benefits.
Example #2: Same Disability but Different Impairment
Two employees work in construction.
Employee A is a heavy machine operator who suffers a spinal cord injury in a forklift accident and undergoes a lumbar fusion.
He receives permanent restrictions after the spinal fusion, primarily due to the radiating pain in his legs that affects his ability to walk.
He cannot do his job with these restrictions, which qualifies him for disability benefits.
In addition, he receives a 35 percent impairment rating for his right leg and a 15 percent impairment rating for his left leg, qualifying him for permanent partial disability.
Employee B suffers a knee injury in a crane accident.
He does not need surgery.
The orthopedic surgeon provides permanent restrictions that prevent the laborer from returning to his pre-injury job. Therefore, he qualifies for disability under workers’ comp.
A post-MMI evaluation, however, finds no impairment under the Guides.
The insurance company will focus on the difference between impairment and disability to limit your claim’s reserve amount and find potential defenses in your case.
Understanding how the legal systems distinguish impairment and disability helps you fight back and get what you deserve.
Contact us today for more information on winning your claim.