Permanent and Stationary (P&S) in California Workers’ Comp: What It Means and What Happens Next

In California workers’ compensation, “permanent and stationary” (P&S) means your doctor has found that your injury has reached maximal medical improvement (MMI): your condition is well stabilized and unlikely to change substantially in the next year, with or without treatment. It does not mean you are healed or that your claim is over. P&S usually ends temporary disability checks and starts the permanent disability evaluation, and you can still be owed medical care for the injury.

What permanent and stationary means

The Division of Workers’ Compensation (DWC) defines it in rule 9785 as the point of maximal medical improvement, when the condition is “unlikely to change substantially in the next year with or without medical treatment.” DWC’s guidebook says that your condition is not improving and not getting worse.

A doctor can find you P&S and still say you need future treatment or lasting work restrictions. That differs from being “released from care,” which the same rule defines as P&S “with no need for continuing or future medical treatment.”

Who decides, and what the P&S report must cover

Your primary treating physician, the doctor managing your care, decides first. That doctor must then report, generally within 20 days of the examination, on permanent impairment and limitations and any need for future care, often on DWC Form PR-4.

If you or the claims administrator disputes the treating doctor’s findings, a qualified medical evaluator (QME) examines you and writes a medical-legal report under Labor Code sections 4061 and 4062. If you have a lawyer, the parties may instead agree on an agreed medical evaluator (AME).

DWC says the report should also cover your work restrictions, whether you can return to your old job, and how much of the disability is caused by work rather than other factors. You have a right to a copy; ask for it in writing.

What changes in your checks

Temporary disability (TD) replaces lost wages during recovery; DWC’s TD chapter lists reaching P&S as one event that ends it. With the last TD payment, section 4061 requires a notice stating the permanent disability (PD) the employer will pay and why, including whether you need future medical care, or that none is payable, or that PD cannot yet be determined.

If PD is owed, section 4650(b) makes the first payment due within 14 days after the last TD payment, then every two weeks. Before an award, no PD payment is required if the employer has offered a job paying at least 85 percent of your wages and compensation at injury, or you are working in one paying at least 100 percent of that amount. When an award issues, that deferred amount runs from the last day covered by TD or the P&S date, whichever is earlier. For 2013 and later injuries with permanent partial disability, if the employer does not offer qualifying work lasting at least 12 months within 60 days after the claims administrator receives the first required physician’s report finding all claimed conditions P&S and permanent partial disability, you are entitled to a job displacement voucher under section 4658.7.

Rating the permanent disability

The doctor’s impairment number is not the final percentage. A rating converts it using your date of injury, age, occupation and any apportionment to other causes; for 2013 and later injuries, section 4660.1 multiplies the whole person impairment by 1.4. The percentage then sets the amount of PD.

If you have no lawyer and a QME evaluated you, DWC’s Disability Evaluation Unit (DEU) calculates a rating from the QME’s report, generally within 20 days after receiving the complete evaluation. If you have not opened a WCAB case, you or the employer can ask the administrative director for reconsideration within 30 days of receiving the rating. Our guide to DEU ratings explains how to read it.

Medical care after P&S

The employer’s duty under section 4600 to provide treatment reasonably required to cure or relieve the effects of the injury does not end at P&S. The P&S report should identify any need for future care. The Ayala award, for example, included “Future medical care to cure or relieve the effects of the industrial injuries.” Our advice: if a report omits care you receive or expect to need, raise it before the claim is rated or settled.

A P&S condition can worsen. Under section 5410, a worker can seek more compensation for “new and further disability” within five years after the date of injury.

If you disagree with the P&S report

If asking the treating doctor does not fix an error or gap, send the claims administrator a letter saying you disagree. DWC’s guidebook warns that in some cases the letter is due within 30 days after you receive the report if you have no lawyer, or 20 days if you do, and that missing the deadline risks losing the right to challenge the opinion. Our advice: send it within that time rather than waiting to learn whether your dispute is one of them.

Without a lawyer, the claims administrator must send you a form to request a panel of three QMEs. You have 10 days to send it to DWC, and then 10 days after the panel issues to choose one, make the appointment and tell the claims administrator. With a lawyer, the parties may agree on an AME or, for injuries on or after January 1, 2005, use a QME panel under section 4062.2. Under section 4062.1, an unrepresented worker who has had a QME evaluation and later hires a lawyer is not entitled to an additional evaluation. Our QME and AME exam guide covers preparing for it.

Our advice: name exactly what you dispute (the P&S date, the impairment, the restrictions or the future care), because each raises a different question for the evaluator.