Understanding the Outcome of an 85 Rating on Workers' Compensation

What Does an 85 Rating Mean?

An 85 rating is a Workers' Compensation Board assessment indicating that the injury results in a severe impairment of the affected body part. It is the highest level of functional loss, excluding total permanent loss, which is rated 100.

How Ratings Are Determined

Medical Evaluation Process

Doctors submit a Detailed Medical Report, which the Board reviews. The rating reflects the permanent functional loss caused by the injury.

Comparison to Other Ratings

Ratings typically range from 0 (no loss) to 100 (total permanent loss). An 85 rating is close to the maximum, showing significant long‑term impact.

Benefits Associated with an 85 Rating

Workers with an 85 rating qualify for higher disability benefits. The exact amount depends on state formulas but generally includes a larger monthly payment and extended medical coverage.

Implications for Return‑to‑Work

Employers may need to provide modified duties or accommodations. The rating helps determine whether a partial or full return is feasible.

Legal and Insurance Considerations

Insurance carriers often review the rating when setting premiums and determining coverage limits. A high rating can influence future claims handling.

Case Example and Common Outcomes

Workers who receive an 85 rating frequently experience long‑term pain, reduced mobility, and require ongoing therapy. Their benefits may cover specialist visits, physical therapy, and assistive devices.

Key Takeaways

• An 85 rating signals a severe, permanent functional loss.
• Benefits are higher than for lower ratings but may still fall short of full replacement.
• Employers should plan accommodations based on the rating.

Fact Table: Rating vs. Benefit Overview