How Injured Employees Can Get Permanent Partial Disability Benefits through Virginia Workers' Compensation for Loss of Use or Loss of Function of a Body Part

When you’re hurt on the job in Virginia you may be entitled to many types of types of workers’ compensation benefits. Permanent partial disability benefits, also known as PPD benefits, can be a significant source of compensation to you and your family.

Permanent partial disability benefits are payable to injured employees who are not totally disabled from all work because of their injuries but who have some type of permanent impairment or functional loss or who are only capable of returning to light duty work. PPD benefits are also available if you suffer pain, scarring, or disfigurement to the injured body part.

To receive permanent partial disability benefits in Virginia, your treating physician must state that you have reached maximum medical improvement. There is no time limit on how long you have to reach maximum medical improvement – some of you will reach it in a few months, whereas others will take a few years because multiple surgeries are required. You should still file a workers’ compensation claim for PPD benefits soon after your injury so that you can protect your rights.

Just ask the Commission not to refer the PPD claim to the hearing docket until requested.

This article examines how you can prove that you suffered a permanent partial disability in your work accident and how Virginia determines the amount of compensation you’re owed for permanent impairment. An experienced Virginia workers compensation attorney can be invaluable in increasing the amount of your PPD benefits or lump sum workers’ comp settlement. Call or email us today for a free consultation.

How Does Virginia Workers' Compensation Calculate Permanent Partial Disability Benefits?

Virginia workers’ compensation uses the scheduled loss approach to PPD benefits. This is the most common approach to permanent partial disability benefits in the United States, with more than 40 jurisdictions using it. Under the scheduled loss approach the Workers’ Compensation Act contains a scheduled, or list, of body parts. If an injured employee suffers the loss of a body part, or the loss of use or function of a body part, on the list, he or she is entitled to PPD benefits.

Section 65.2-503 of the Virginia Workers’ Compensation Act governs claims for permanent partial disability benefits. It covers loss of a thumb, finger, toe, hand, arm, foot, or a leg. PPD benefits are available if you lose the body part completely, or if you lose some functional ability because of the injury. PPD benefits are also available for vision loss

Virginia’s PPD statute establishes a conclusive presumption that disability will last for the number of weeks specified in the statute. Below are the number of weeks assigned to each injured body part for PPD purposes:

  • Thumb: 60 weeks
  • Index finger: 35 weeks
  • Second finger: 30 weeks
  • Third finger: 20 weeks
  • Little finger: 15 weeks
  • Big toe: 30 weeks
  • Other toes: 10 weeks
  • Hand: 150 weeks
  • Arm: 200 weeks
  • Foot: 125 weeks
  • Leg: 175 weeks
  • Loss of Vision: 100 weeks

As you can see, some injuries are assigned greater value than others. This leads to discrepancies in settlement amounts and PPD awards. The higher the value placed on your injury by the General Assembly, the more your case is likely worth.

Often we are asked if permanent partial disability benefits are available if the injured employee did not miss any time from work. This happens when employer accommodate the injured worker’s light duty restrictions and pay him or her the same wages as before the injury.

The answer is Yes, you can receive PPD benefits even if you did not miss any time from work or lose any wages. PPD benefits are payable even if you never received temporary total disability benefits or temporary partial disability benefits.

Amount of Permanent Partial Disability Benefits

When you reach MMI your attorney will write a detailed letter to your treating physician. The letter will ask for several things, one of which is a permanent impairment rating. A permanent impairment rating tells the percentage loss of use of the injured body part.

Permanent impairment ratings are not considered “medical treatment” under the Virginia Workers’ Compensation Act. The employer and its insurance company do not have to pay for these ratings. If your doctor refuses to give you one for free, then your attorney will likely send you to a claimant-friendly physician for the sole purpose of providing a permanent impairment rating. A persuasive disability report that provides a high impairment rating increases the value of your PPD claim.

In Virginia your weekly wage loss compensation rate is a fraction of your pre-injury average weekly wage. The number of weeks of benefits at this rate is taken from the PPD schedule and multiplied by your average weekly wage and percentage impairment. This is the amount of PPD benefits you’re entitled to.

For example, an injured employee hurt their right shoulder on the job. When that employee reaches maximum medical improvement their treating physician states they have a 40% permanent impairment to the right arm because of the shoulder injury. If that employee earned $1200 per week before the work accident, he or she would receive $64,003.20 in permanent partial disability compensation (a compensation rate of $800.04 x 200 weeks x .40).

What if the Insurance Company Disagrees with My Proposed Permanent Impairment Rating?

If your workers’ comp lawyer sends you to a claimant friendly physician for a PPD rating, the insurance company will likely disagree with the rating. This is just business as usual. Many claims adjusters assume that if you chose the doctor, the rating overstates your permanent functional limitations.

In response, the insurance company may send you to a doctor of their choosing for an independent medical examination (IME). The IME doctor will provide a report that includes a permanent impairment rating. Usually the IME rating is much lower than the rating from your doctor.

What happens if the injured employee and the insurance company disagree on the level of permanent impairment? The parties will go to a hearing before a deputy commissioner. At the hearing the deputy commissioner will either:

  • average the two ratings to come up with a new permanent impairment rating or
  • find one of the impairment ratings more persuasive than the other and award PPD benefits using the more persuasive rating.

What if I Had an Earlier Injury for Which I Received PPD Benefits?

Those of you with physically demanding jobs have likely suffered more than one work related injury during your career. If you received a prior award for disfigurement or loss of use, the commission may deduct the amount of PPD benefits you receive for any subsequent injury. This is why it’s important to have your permanent impairment rating doctor address any pre-existing conditions.

What if I'm Unable to Return to Work Based on My Permanent Restrictions and PPD Impairment Rating?

If you’re unable to return to work because of your industrial accident or occupational disease, you may qualify for other types of benefits. One such benefits is Social Security Disability.

The Social Security Administration (SSA) evaluates claims for disability benefits using a different analysis than workers’ comp. Depending on your age, education, and transferable job skills, you may qualify for benefits under the SSDI or SSI programs.

Richmond Social Security Disability lawyer Corey Pollard routinely helps injured employees qualify for PPD and SSDI benefits at the same time. You do not have to pick one benefit or the other.

Get Help with Your Permanent Partial Disability Claim (PPD) from an Experienced Workers' Comp Attorney

PPD claims in Virginia are rarely straightforward. An experienced lawyer can help you increase the amount of benefits you receive for permanent loss of use, amputation, loss of function, disfigurement, or scarring. If you’ve sustained permanent injury because of your Virginia work accident, Richmond workers compensation lawyer Corey Pollard will help you by:

  • Working with your treating physician to develop a plan to treat your permanent loss of use or loss of function of the injured body part
  • Educate your treating physician on how the Virginia Workers’ Compensation Commission evaluates claims using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides)
  • Explain to your treating physician what should be included in a disability report and impairment rating to increase your chance of receiving PPD benefits
  • If your treating physician is unwilling to provide a PPD rating, find a claimant-friendly physician who will evaluate your physical abilities and provide a supportive permanent impairment rating
  • Negotiate with the insurance company to increase your PPD benefits
  • Present your PPD claim at trial, if necessary.

You have nothing to lose by calling us. Contact us today for a free consultation. We’ve helped injured employees like you increase the value of their work injury claims.