We often get calls or e-mails from injured workers. They have received a permanent partial disability benefits check in the mail paying them a lump sum of money after the doctor has given them an impairment rating. They wonder why they are getting a check and what it is paying.
Many of them have concerns over whether this is the end of their workers’ compensation case. Is this check a settlement check? If they cash the check, will it end their case?
This article on permanent partial disability benefits will discuss the answers to these questions and a few others as well.
Permanent Partial Disability Benefit Overview
People with serious injuries often suffer permanent impairment. Permanent partial disability benefits are how the workers’ compensation system pays you for permanent impairment that you may have because of your work injury.
You only receive permanent partial disability benefits if you have some permanent impairment from your injury. Because of this, the doctor will probably not give you a permanent partial disability rating until the doctor places you at “maximum medical improvement”. Maximum medical improvement means the doctor thinks your injury is as good as it is going to get.
How Does the Doctor Come Up with a Rating
When you reach this point, the workers’ compensation law requires your treating doctor to use a book that is published by the American Medical Association to determine your disability rating. This book is called the Guides to the Evaluation of Permanent Impairment.
Georgia law currently requires doctors to use the 5th edition of that book. This book attempts to provide ratings for any type of injury suffered to any part of the human body.
Using this book, the doctor will determine a permanent partial disability rating. This rating will either be to a specific body area (finger, hand, upper extremity, etc.) or to the “body as a whole”.
When Permanent Partial Disability Benefits Start
Before you can receive PPD benefits, you first have to had a permanent partial disability rating. Your doctor will give you that.
Also, under Georgia law, your employer does not have to start paying you permanent partial disability benefits until you stop receiving temporary total and temporary partial disability benefits. If your temporary total disability benefits stop and the doctor has not yet given you a PPD rating, the law requires your employer to request a rating.
Once you stop receiving temporary total disability benefits and have a PPD rating, the law requires your employer to start paying PPD benefits. Your employer must start paying the benefits within twenty one days.
So, if your doctor has not given you a PPD rating yet when your temporary disability benefits stop, it may be a month or more before you start receiving PPD benefits. If you already have a rating, you should start receiving those benefits quicker.
How Long Are Permanent Partial Disability Benefits Paid
When your employer starts paying permanent partial disability benefits, they can pay it in two different ways:
- They can pay the entire amount in one lump sum payment
- They can pay benefits the benefits on a weekly basis
If the employer starts paying you weekly benefits, the amount per week will be the same as what you receive for temporary total disability benefits (see how that amount is calculated here). The number of weeks that you will receive benefits will depend on:
- How high a disability rating the doctors gives you; and
- What part of your body was rated.
Different Types of Ratings and What They Mean
The most common disability rating is to the “body as a whole”. This type of rating pays you receive three weeks of benefits for every one percent that you are rated. So, a 10% disability rating to the body as a whole will pay you 30 weeks of permanent partial disability benefits.
You might receive a rating to a specific part of your body. The most common type is a rating to the upper extremity or lower extremity. If you receive an upper or lower extremity rating, then you will receive 2.25 weeks of benefits for every percent of the rating. So, a rating of 10% to the upper extremity would pay you 22.5 weeks of benefits.
There are also a number of other specific body part ratings and each one of them entitles you to a different number of weeks of benefits per percent that you are rated. Just take a look at this article if you would like more information about all the different specific body part ratings.
Will Cashing A Permanent Partial Disability Check End My Case?
Sometimes, the insurance company pays your permanent partial disability benefits in a lump sum. Other times, they pay these benefits weekly. Regardless of which way they pay them, acceptance of permanent partial disability checks does not settle or end your case.
In order to settle your workers’ compensation case in Georgia, the following things would need to happen:
- You sign paperwork agreeing to settle your case for a certain amount of money;
- An insurance company representative signs that same paperwork; and
- A judge at the Georgia State Board of Workers’ Compensation approves that settlement paperwork.
When the insurance company pays you a check for permanent partial disability benefits, they are simply paying you something they owe you under the law. Settlement is different. Settlement involves an agreement to give up your case in exchange for money.
Although acceptance of this check will not settle your case, you should remember that time limits (called statutes of limitation) may affect how long you have to pursue additional workers compensation benefits. The rules on these deadlines are tricky.
Many people find it difficult to determine how long they have to pursue additional benefits for wage loss, medical treatment, or permanent partial disability. Waiting too long often means that you do not receive the benefits that you should.
Contesting an Incorrect Permanent Partial Disability Rating
Another concern many people have about accepting permanent partial disability benefits is that the disability rating may be incorrect. They also believe that accepting the permanent partial disability check may mean that they legally agree with the rating.
You can still disagree with the permanent partial disability rating the doctor gave you even if you accept some or all of checks that the insurance company pays you. Generally, the way that you would contest the amount of a PPD rating is by filing a Form WC-14 requesting a workers’ compensation hearing.