One of the three basic benefits available under Georgia’s workers’ compensation laws is permanent partial disability benefits. Often, permanent partial disability benefits are known by one of the following two abbreviations:
- PPD (permanent partial disability); or
- PPI (permanent partial impairment).
Most people become aware of permanent partial disability benefits when their treating workers’ compensation doctor discuss an impairment rating or gives them an impairment rating. Other times, an impairment rating may get mentioned to you by an insurance adjuster or a nurse case manager.
What is a permanent partial disability rating?
A permanent partial disability rating is a percent rating that you receive when your doctor determines that you have a permanent impairment as a result of your workers’ compensation injury. Your doctor will usually give you this rating when they determine that you have reached maximum medical improvement.
Under Georgia law, workers’ compensation doctors have to use a book called the American Medical Association Guides to the Evaluation of Permanent Impairment when determining your impairment rating. Doctors are required to use the fifth edition of this book.
This book is over 600 pages long and attempts to provide a rating for any impairment you might have as a result of any sort of injury. I have a copy of this book in my office.
Your workers’ compensation doctor will use this book to give you a permanent partial disability rating. First, the doctor will find the right section of the book to address your type of injury. Then the doctor may need to do some measurements to reach the correct rating.
What happens after I get a permanent partial disability rating?
Permanent partial disability ratings entitle you to receive permanent partial disability benefits from the workers’ compensation insurance company. You usually receive these benefits on a weekly basis (although the insurance company may choose to pay you in a lump sum instead).
Your permanent partial disability rating determines how many weeks you receive these benefits. In order to know how many weeks you will receive benefits, you need to know the percent impairment rating plus the part of the body that the doctor rated.
Each part of your body has a certain number of weeks assigned to it under Georgia law. The body as a whole is assigned 300 weeks of benefits. Each upper extremity (arm) or lower extremity (leg) is assigned 225 weeks of benefits. Other body parts have different numbers of weeks assigned to them.
To determine the number of weeks of benefits you receive, you need to know the total weeks of benefits for that body part and then your percent rating. You then take the percentage of the total number of weeks for that body part.
For example, if you receive a 10 percent rating to the body as a whole. Georgia law assigns a total of 300 weeks to the body as a whole. A 10 percent rating to the body as a whole entitles you to 10 percent of that 300 weeks. So, a 10 percent rating to the body as a whole entitles you to 30 weeks of benefits.
Is my permanent partial disability rating correct?
Georgia law requires that doctors use the fifth edition of the AMA Guides to the Evaluation of Permanent Impairment to give you a PPD rating. So, to know whether your permanent partial disability rating is correct you or an attorney representing you would need to check it against that book.
I have seen many situations where a doctor does not provide the correct rating. You want to make sure you receive the right rating because, the higher the rating that you receive, the more weeks of permanent partial disability benefits you are going to receive from the workers’ compensation insurance company.
What can I do if my rating is not correct?
If a doctor does not provide the correct impairment rating, you will want to get it fixed. Some of the different steps that could be taken to get the correct rating:
- The doctor who provided the impairment rating could change it and give you the correct rating
- You could get an evaluation from another doctor and have that doctor provide the correct rating
- The insurance company could agree on the correct impairment rating
The best way to approach getting your rating corrected will depend on the particular facts of your case.