What Determines My Permanent Impairment Rating?

Unfortunately, some serious injuries do not completely heal.  Even with very good medical treatment and a great doctor, these injuries can cause some amount of permanent impairment.  Sometimes this permanent impairment is reduced strength.  Other times it is reduced range of motion.

Georgia’s workers compensation system considers permanent impairment from an injury when deciding what workers compensation benefits you can receive.  If you do not have a one hundred percent recovery from your injury at work, then you have a permanent impairment.

When this happens, your doctor should determine the amount of your permanent partial disability.  But, how does that happen?

What is permanent partial disability?

Before discussing how doctors determine permanent impairment ratings, I would like to explain a little bit about what permanent impairment is.  There are two different terms that workers compensation uses to describe permanent impairment.

1. Permanent partial impairment which is often abbreviated as PPI
2. Permanent partial disability which is often abbreviated as PPD.

There is really no difference between permanent partial impairment and permanent partial disability.  Both of these terms really mean the same thing.

The official term used in Georgia is permanent partial disability, but some doctors will refer to it as permanent partial impairment.  The idea behind permanent partial disability is that you receive some compensation if you suffer a permanent loss of function as a result of your work-related injury.

The amount of compensation will depend on the percent rating that you receive as well as how much you were earning before you got hurt.  Georgia’s workers compensation laws have a concept known as average weekly wage.

In most circumstances, your permanent partial disability weekly payment is two-thirds of your average weekly wage.  But, there is also a maximum partial disability benefits amount which varies depending on the date you were injured.  Because of this maximum amount, some people’s weekly permanent partially disability payments are less than two-thirds of their average weekly wage.

When does a doctor determine my permanent partial disability rating?

In order for you to have a permanent partial disability rating, your injury must be expected to be permanent.  So, doctors generally wait until you reach maximum medical improvement before assigning you a permanent partial disability rating.

Maximum medical improvement is basically a concept that says you are as good as you are likely to get in recovering from your injury.  It does not necessarily mean that you will not improve anymore.  it just means that doctors have done everything for you that they can at this point, and they really do not see anything more to offer you medically.

Sometimes, doctors will disagree about whether you have reach maximum medical improvement.  This can result in one doctor assigning you a permanent partial disability rating and another saying that it is too soon to assign a rating.

How do doctors determine permanent partial disability ratings?

There was a time when doctors did not have any set standards for determine permanent partial disability ratings.  As you might expect, this led to unfairness because the doctor would just pick the percent rating the doctor thought was fair.  Picking a rating out of thin air without guidelines did not result in consistent ratings that reflected the amount of permanent loss of function.  This was not fair.

Fortunately, Georgia workers compensation law adopted a method that doctors must follow now when they determine the amount of permanent partial disability.  Georgia law now requires doctors to use a certain book to give you a permanent partial  disability rating.

The book that doctors are required to use is called The American Medical Association’s Guides to the Evaluation of Permanent Impairment.  Doctors are required to use the 5th edition of that book.  It is over 600 pages long.  Within those 600 pages, it tries to cover any sort of impairment that you might suffer as a result of an injury or a disease.

If you reach maximum medical improvement and your doctor thinks that you may have some permanent impairment, they should consult the Guides to the Evaluation of Permanent Impairment book to determine what your rating should be.  The Guides to the Evaluation of Permanent Impairment has 18 different chapters.  16 of these chapters focus on body systems.

Here are some of the chapters of the book that are used most often in workers compensation cases:

• Chapter 13 – The Central and Peripheral Nervous System – serious injuries often result in some form of nerve damage
• Chapter 15 – The Spine – this chapter covers injuries to the back and neck
• Chapter 16 – The Upper Extremities – this chapter covers injuries to the shoulders, arms, and hands
• Chapter 17 – The Lower Extremities – this chapter covers injuries to the legs and feet

By looking at the appropriate chapter for your injury, the doctor will get instructions on how to determine your permanent partial disability rating.  The doctor will then assign a rating to the body as a whole or to some specific part of your body.

How does that permanent partial disability percentage rating compensate me for my loss of function?

The percent rating you receive affects the number of weeks of permanent partial disability benefit checks you will receive.  The higher the rating given by a doctor, the more weeks of benefits you will receive.

But, different parts of your body also have a different number of weeks of benefits assigned to them.  Because of this, it matters whether the doctor give you a rating to the body as a whole, to the upper extremity, or to some other specific part of your body.

Sometimes, your doctor will assign you multiple ratings.  For example, it is fairly common for a doctor treating a shoulder injury to provide a rating to the body as a whole and a different rating to the upper extremity.  Georgia law has rules for determining which rating should be paid when you receive multiple ratings for the same injury.

If you want to find out more about how long and how much you receive based on different types of ratings, I wrote another article that discuss that.  You can read it by clicking here.

Is my permanent partial disability rating affected by the seriousness of my injury or how long it takes me to reach maximum medical improvement?

Not necessarily.  Permanent partial disability ratings are looking at the permanent loss of function from an injury.  Some injuries take a long time to reach maximum medical improvement and result in very little or no impairment.  An example of this is a had injury which requires multiple surgeries but ultimately results in the full recovery of function.

Other injuries reach maximum medical improvement quickly but have substantial impairment.it may only take a few months to reach maximum medical improvement.  An example of this is an amputation of multiple fingers.  An individual may heal up and reach maximum medical improvement pretty quickly, but there is substantial permanent impairment.

Many people get frustrated by this because of the amount of time they spend in pain recovering from their injury.  Unfortunately, Georgia’s workers compensation law does not look at the amount of time you spend in pain.  It only looks at the permanent loss of function from your injury with regard to payment of permanent partial disability benefits.