What Is a Permanent Impairment Rating? (Charts Included)

Person in a wheelchair preparing to cross the road at the crosswalk.

It’s bad enough that you’ve been hurt on the job.

You want to get better and return to work, but you don’t want to go back to work too soon and risk further injury or hurt your chances for a full recovery. Most people who’ve been through a workers’ compensation claim can tell you, things can get complicated pretty quickly. And your recovery may often seem like it gets lost among the noise of this complicated machine known as the workers’ compensation system.

Oftentimes, insurance companies will send injured workers to doctors they prefer. We’ve seen over and over that sometimes these doctors may clear our clients to go back to their jobs before they feel ready.

If you don’t feel you are medically ready to return to your job, contact us immediately. We may be able to help you get another doctor’s opinion.

What Is Maximum Medical Improvement (MMI)?

Maximum medical improvement is the point in an injured worker's healing process where no improvement is expected with generally accepted medical treatment.In workers’ compensation language, when your healing period ends, you have reached reached “maximum medical improvement,” or MMI.  If you have made a complete recovery and have no pain or loss of function, your doctor will likely record in your medical records that you have made a 100% recovery and you are back to normal – the way you were before your injury.

However, if you still have deformity, pain, weakness, or loss of function that has not improved through medical treatment, your doctor may assign you a “permanent impairment rating.” A permanent impairment rating is supposed to reflect the percentage of change from your normal pre-injury condition. If you receive this rating, it is applied to a workers’ compensation injury chart (which is broken down by body part) to determine your benefits.

Permanent Impairment Rating is the percent change from pre-injury condition.

If you don’t agree with this rating, or you don’t feel medically ready to return to your job, we can help you take the necessary steps to try to get a second opinion with a doctor you choose. Not necessarily one the insurance company chooses!

NC Permanent Impairment Chart: Total Loss Compensation

Most of our clients are shocked to learn that North Carolina state law sets a maximum amount of compensation for each body part. Here is a list of the maximum number of weeks you could receive benefits for a total loss of body parts: 


NC Compensation for a Permanent Impairment
Body Part Weeks of Compensation for a Complete Loss
Thumb 75 weeks
First Finger 45 weeks
Second Finger 40 weeks
Third Finger 25 weeks
Fourth Finger 20 weeks
Big Toe 35 weeks
Other Toe 10 weeks
Hand 200 weeks
Arm 240 weeks
Foot 144 weeks
Leg 200 weeks
Eye 120 weeks
Back 300 weeks


NC Permanent Impairment Chart: Partial Loss Compensation

For anything less than total loss, benefits are figured on a percentage basis. For example, a 10% partial impairment rating to the leg would be worth 20 weeks of benefits at your average weekly wage rate. A 10% rating to your back would be worth 30 weeks at your weekly compensation rate.

Based on a 10% Permanent Partial Impairment Rating


NC Compensation for a Permanent Partial Impairment
Body Part Weeks of Compensation for 10% Rating
Thumb 7.5 weeks
First Finger 4.5 weeks
Second Finger 4 weeks
Third Finger 2.5 weeks
Fourth Finger 2 weeks
Big Toe 3.5 weeks
Other Toe 1 weeks
Hand 20 weeks
Arm 24 weeks
Foot 14.4 weeks
Leg 20 weeks
Eye 12 weeks
Back 30 weeks


The North Carolina Industrial Commission publishes a ratings guide to help physicians make impairment evaluations. Here are those rating guidelines that include impairments such as the following:

  • Shortening of the leg
  • Rotation of the hip
  • Motion of the knee, foot, and ankle
  • Optimum position of the fingers, elbow, and shoulder
  • Fractures
  • Lacerations
  • Nerve injuries
  • Back injuries
  • And more

If your workers’ comp claim has been approved, you are likely entitled to receive this payment for permanent impairment even if you are able to go back to work and even if you don’t have any reduction to your wages. This partial workers’ compensation settlement is made in a lump sum, usually when the injured worker goes back to work for the same employer earning the same wages as before the injury. Under this kind of partial settlement, the injured worker retains the right to request additional medical treatment for another two years.

If you disagree with the doctor’s rating, you are entitled to get a second opinion from another doctor of your choosing. The Industrial Commission will average the two ratings to determine what workers’ compensation benefits you may be entitled to.

If, however, your healing period ends and you are still unable to return to work, you can choose to continue receiving weekly compensation checks instead of payment for your disability rating. Except under special circumstances, you can only receive weekly benefits for a total of 500 weeks from the date you became disabled.

Complicated, isn’t it?

Insurance companies get to direct your care after an on-the-job injury. If you have been cleared by a doctor to return to work but do not feel medically ready to do so, call us today for a free case evaluation.

Bottom Line for Injured Workers: Talk to an Experienced Workers’ Compensation Attorney


Lawyer and an injured client wearing an arm sling shaking hands.

Workers’ compensation laws can be extremely confusing and complicated. That’s why we believe it’s best to have legal guidance to help you try to make the right decisions at every step of this process. Our workers’ compensation lawyers have the training and the experience to help you potentially get the medical treatment and compensation you need.

Get Your Workers’ Compensation Case Evaluated for Free

Many of us are North Carolina State Bar Board Certified Workers’ Compensation Specialists.

Out of the less than 31,500 attorneys licensed to practice in North Carolina, fewer than 175 can claim that distinction.* We also have a former Special Deputy Commissioner, and a former Deputy Commissioner from the North Carolina Industrial Commission (one of whom was a state senator).

When you’re injured, the last thing you need is to try to become a workers’ compensation attorney and decipher a workers’ comp settlement chart in order to figure out what workers’ comp benefits you may be entitled to. We can do that for you. You just need to focus on getting better and trying to get a check to put food on the table for your family during your recovery.

Contact us online to let our highly experienced workers’ comp team evaluate your case for FREE, or call on our 24/7 North Carolina workers’ comp hotline at 1-866-900-7078.

*NC Board Certification figures provided by the NC State Bar through January 2022.

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About the Author

Susan Vanderweert practices workers’ compensation law in North Carolina for the Law Offices of James Scott Farrin. Previously, she represented the other side – insurance companies and employers – but moved on to fight on behalf of employees. Susan is a North Carolina State Bar Board Certified Specialist in Workers’ Compensation Law, and she was selected by peers to the annual “Best Lawyers”a list for Workers’ Compensation Law in 2021 and 2022 by Best Lawyers in America.

aFor more information regarding the standards for inclusion, please visit www.bestlawyers.com.