Impairment ratings are significant because they can play a role in determining permanent partial disability compensation. Claimants with legal representation also tended to receive more diagnostic testing as part of their treatment, but this finding was not moderated by ethnicity. If the patient doesn't have legal representation, however, inherent biases have a way of working their way into the situation. So, while having an attorney involved in a disability case can lengthen the time from injury to settlement, it may be an effective strategy for coping with inequities in the Workers' Compensation system, especially for African-Americans. In the Missouri Workers' Compensation system, employees injured on the job are required to see physicians retained by their employers.
Some workers receive temporary disability payments while they undergo treatment.
When a physician determines a worker has reached maximum medical improvement, the worker is assigned an impairment rating. This rating is taken into consideration by an administrative law judge who mediates the determination of permanent partial disability compensation. Usually, the higher the rating, the higher the compensation. The study also found that ethnicity differences disappeared at the level of the administrative law judge, probably because nearly all claimants had legal representation by this stage of the process. They also chose it because low back pain is subjective and difficult to evaluate diagnostically.