Permanent Partial Disability Settlement Amounts in Workers Compensation

 

Injured Workers Can Receive Compensation for Permanent Partial Disabilities from an Industrial Accident

 

 

Many work accidents lead to permanent impairment of the injured body parts. 

 

If your work-related injury or occupational disease results in lifelong problems, scarring, disfigurement, or loss of vision or hearing, you may qualify for compensation for permanent partial disability. 

 

Permanent partial disability benefits, called PPD for short, can be a significant source of income for you and your family as you start over after a workplace incident. 

 

This article explains when you qualify for a permanent partial disability settlement, focusing on how Virginia workers compensation law treats PPD claims. 

 

But despite this focus, the information below will help serve as a starting point as you try to obtain permanent partial disability benefits available in your state. 

 

I hope you find this guide to workers comp PPD helpful.  

 

Do not hesitate to call (804) 251-1620 or (757) 810-5614 if you have questions about your legal options after a work injury. We have negotiated millions in workers compensation settlements. 

 

 

Definition of PPD: What is Permanent Partial Disability? 

 

Many state statutes provide definitions of permanent partial disability. 

 

For example:

 

• In Virginia, Code Section 65.2-503, Permanent Loss, states, “Compensation for permanent partial and permanent total loss and disfigurement shall be awarded as provided in this section.” 

 

• In Georgia, “‘permanent partial disability‘ means disability partial in character but permanent in quality resulting from loss or loss of use of body members or from the partial loss of use of the employee’s body.” 

 

• In New Jersey, “‘disability permanent in quality and total in character‘ means a physical or neuropsychiatric total permanent impairment caused by a compensable accident or compensable occupational disease, where no fundamental or marked improvement in such condition can be reasonably expected.” 

 

Curating these PPD definitions, we submit that permanent partial disability means a permanent impairment from a compensable work accident that restricts the body’s function or use of its members, lessening your working ability. 

 

What Occupational Injuries May Result in Permanent Partial Disability?

 

Any work-related injury that causes enduring and partial disability may qualify for permanent partial disability benefits.

 

I recommend consulting with an attorney to see if you qualify for PPD benefits for injuries other than minor contusions (bruises), minor lacerations (such as those not requiring stitches), minor strains, and minor sprains.

 

Is It Common to Have Permanent Partial Disability from a Work Accident?

 

Yes. 

 

Compensation for permanent partial disability accounts for a large percentage of total cash payments and claim costs in workers compensation. For example, various studies have concluded that permanent partial disability payments account for more than half of all income benefits paid to injured workers.

 

In addition, another study found that over half of work-related injuries in which temporary total disability lasts more than one week resulted in permanent partial disability. 

 

Can I Receive Money for Permanent Partial Disability under Workers Compensation? 

 

Yes.

 

All 50 states provide permanent partial disability benefits as part of their workers compensation systems. 

 

PPD payments are among the four types of workers compensation benefits that provide cash to injured employees. 

 

The other three direct cash benefits are temporary total disability (TTD), temporary partial disability (TPD), and permanent and total disability (PTD). 

 

How Do I Prove Permanent Partial Disability?

 

At a minimum, you must prove two things by a preponderance of the evidence to receive workers comp PPD.

 

First, you must prove that you have reached maximum medical improvement (MMI) for your work-related injury. Usually you satisfy this prong of the test through a doctor’s report stating you have reached MMI and to return as needed. 

 

Second, you must obtain a permanent impairment rating that quantifies the loss of use of the injured body part. Typically a doctor calculates your impairment using the AMA Guides to the Evaluation of Permanent Impairment. 

 

A speculative statement that you will likely have permanent impairment due to the work accident is insufficient to get PPD. You need an actual rating.

 

Does Compensation for Permanent Partial Disability Depend on Work Status?

 

No. 

 

You can receive PPD benefits even if you have never missed a day from work because of an occupational injury or illness. 

 

As the Court of Appeals of Virginia stated, permanent partial disability benefits are for the loss of “human capital.”

 

Workers compensation presumes your injury affected your earning capacity if you have a scheduled permanent bodily impairment, even if your doctor released you to full-duty work or you have found a light-duty job with no wage loss. 

 

Differences Between PPD and Full and Final Settlements

 

Most states allow the parties to negotiate a lump sum settlement that closes the workers compensation case. 

 

A treating doctor’s declaration that you have reached MMI is often an excellent time to settle your claim. 

 

For example, many workers compensation cases settle when the injured employee gets rated for permanent partial disability because 

 

• The parties now know what permanent restrictions you will have

 

• You can predict future medical expenses 

 

But, if the parties do not settle for whatever reason, many insurers and claim administrators will stipulate the impairment rating and the amount of PPD benefits owed. 

 

Some employees call this stipulation a permanent partial disability settlement. However, it differs from negotiating a traditional lump sum settlement. 

 

Resolving the claim for PPD benefits by stipulation instead of settlement enables you to continue receiving medical care at the employer’s expense. 

 

In addition, depending on the other facts of your case, you may have the right to file a change in condition application seeking the reinstatement of wage loss benefits.

 

Methods for Calculating Permanent Partial Disability Settlement Amounts

 

The correct approach to assessing permanent loss of use and determining PPD payments depends on which state has jurisdiction over your claim. 

 

These different approaches to workers comp PPD explain how an injured worker with a rotator cuff tear in one state may receive tens of thousands of dollars more in permanent partial disability benefits than an injured worker in a different state with the same injury, impairment rating, and pre-injury wages. 

Despite the variability, the methods used by states to assess the extent of permanent disability can be broadly categorized into four distinct approaches, each with its own implications:

 

• Impairment Approach (Scheduled Loss of Use): This method pays permanent partial disability benefits if you have a quantifiable loss of use (total or partial) of a scheduled body part. A scheduled body part is one listed in the state’s statutes. Virginia uses this approach. 

 

• Impairment Approach (Unscheduled Loss of Use): This method pays PPD benefits for an unscheduled permanent partial disability, usually based on whole-body impairment. Whole-body impairment ratings help in states that do not consider head trauma, concussions, traumatic brain injury (TBI), spinal cord injury, or injuries to the back or neck as scheduled members. 

 

• Wage-Loss Approach: With this method, compensation for permanent partial disability depends on your actual or ongoing wage loss from the occupational injury. 

 

• Loss-of-Earning-Capacity Approach: This method pays PPD benefits if you present evidence, usually in the form of a labor market survey, that you have a permanent loss of earning capacity due to your work injury or occupational disease. 

 

Formula for Calculating Permanent Partial Disability Settlement Amounts Using the Body Part Chart

 

So, you have proven a compensable work injury, reached MMI, and obtained a permanent impairment rating. 

 

Now you are ready to calculate your permanent partial disability settlement. 

 

Step One: Find the PPD Schedule

 

The first step in a state that follows the scheduled loss of use approach is to find the chart that lists the covered body parts. 

 

For example, Code Section 65.2-503(B) is Virginia’s statute for permanent partial disabilities. 

 

This code section includes a schedule of body parts and the number of weeks available for permanent partial disability (total or partial) for each body part.  

 

Below is the permanent partial disability chart for occupational injuries and diseases in Virginia. Your state likely has a similar one. 

 

Schedule for Permanent Partial Disability (PPD) Payments

 

Step Two: Should I Use the Impairment Rating for the Entire Limb of the Specific Body Part Injured When Claiming PPD? 

 

As odd as it may seem, workers comp values some body parts more than others.

 

The arbitrary scheduled loss of members results in discrepancies in settlement amounts and payouts of permanent partial disability awards. Indeed, this is natural, as the higher the value placed on your injured body part by the General Assembly, the more your case is likely worth.

 

Generally, you should use the body part assigned the highest number of weeks of PPD. 

  

For example, suppose you suffer a work-related wrist injury.

 

In this situation, you may choose to get a disability rating for either your hand or arm. 

 

The workers comp schedule of loss provides more weeks for loss of use of the upper extremity than the hand; therefore, you will likely receive more compensation for partial disability with an impairment rating for the arm.

 

But remember to read the case law before deciding what type of rating to get.

 

For example, unless the wrist injury impacts the use of your arm toward the elbow and above, the Commission may refuse to recognize permanent partial disability of the entire extremity and require you to present evidence limited to functional loss of only the hand.

 

Step Three: Multiply the Impairment Rating Percentage by the Maximum Weeks of Compensation for Permanent Partial Disability Allowed

 

A 100 percent impairment rating is rare.

 

Indeed, even a 50 percent impairment rating is rare unless you require total joint replacement for the occupational injury.

 

You will likely receive a lower rating that you must multiply by the maximum compensation period.

 

This calculation gives you the number of weeks of permanency you qualify for.

 

Step Four: Multiply Your Compensation Rate and the Number of Weeks of Permanency You Qualify For

 

The last step in calculating your potential PPD settlement amount is multiplying your compensation rate (usually two-thirds of your pre-injury average weekly wage) by the number of weeks of permanent partial disability benefits you qualify for, which you calculated in step two. 

 

This calculated number is the total PPD amount you will receive. 

 

What is the Average Permanent Partial Disability Settlement in Workers Comp? 

 

Based on my experience resolving hundreds of PPD claims and reviewing data, including reports from the Workers Compensation Research Institute, the average workers compensation permanent partial disability settlement ranges from $22,500 to $67,500 in Virginia. These PPD amounts are higher than the national average. 

 

However, calculating the average lump sum award for permanent partial disability is challenging for several reasons:

 

• The data is not easily accessible.

 

• Many claims settle, closing the indemnity and medical parts of the case, when the PPD claim becomes ripe for adjudication.

 

• Some persons with severe permanent partial disability do not receive PPD benefits because other indemnity benefits continue until the cap.

 

PPD Settlement Calculator Examples: Amounts by Impairment Rating

 

Calculating how much you will receive in permanent partial disability benefits is easier to understand with examples. 

 

Here are three PPD examples using five, ten, and fifteen percent impairments to various body parts. 

 

Example 1: 5% Impairment Rating Lump Sum

 

You suffer injuries in a work-related car crash, ultimately receiving the diagnosis of thoracic outlet syndrome. 

 

This condition affects your right arm, and you receive a five percent impairment rating to the right upper extremity. 

 

Suppose you earned $1,200 per week when you were injured, which gives a compensation rate of $800. 

 

This five percent impairment rating equals a payout of $8,000 ($800 x 200 weeks x .05).  

 

Example 2: 10% Impairment Rating Payout

 

You suffer an Achilles tendon tear in a slip and fall at work. 

 

After you reach MMI, the orthopedic surgeon finds you have a ten percent impairment to the leg (lower extremity). 

 

Suppose you earned $1,500 per week when you were hurt, which gives a compensation rate of $1,000. 

 

This ten percent impairment rating equals a PPD benefit amount of $17,500 ($1,000 x 175 weeks x .10). 

 

Example 3: 15% Impairment Rating Amount

 

Suppose you work at an Amazon warehouse and suffer a hand injury when operating a forklift. 

 

You earned $900 per week when the accident occurred, which gives a compensation rate of $600. 

 

Your doctor finds you have a fifteen percent impairment rating for the hand. 

 

This fifteen percent rating equals $13,500 in permanent partial disability benefits (150 weeks x $600 x .15).

 

What Factors Increase the PPD Amount?

 

Several factors increase the likelihood that you will get permanent partial disability benefits after your work injury stabilizes, such as:

 

• Age (with other factors held constant): At least one study found that the older you are, the more money you get for partial disability.

 

• The longer it takes to get medical care or your first wage loss payment, the greater the probability you will receive permanent partial disability payments. A potential explanation for this correlation is that delayed treatment could hinder a full recovery. 

 

• The more time you miss from work, the more likely you are to seek and get permanent partial disability benefits. For example, injuries significant enough to cause you to miss months of work are likely severe enough to result in high impairment ratings. 

 

Can I Receive More PPD if I Have Pain? 

 

Generally, no. 

 

Workers comp does not allow direct payments for pain and suffering. 

 

However, the AMA Guides allow medical practitioners to consider pain when evaluating permanent partial disability if this pain affects your ability to use the body part. So, pain indirectly increases the impairment rating and PPD amount.

 

Therefore, we recommend reviewing the PPD report to ensure it considers your pain before you litigate the claim for permanent partial disability. 

 

How Do I Get PPD for Impairment to Unscheduled Body Parts? 

 

In most states, you can receive permanent partial disability payments for functional loss of unscheduled (unlisted) injuries.

 

Virginia, however, does not pay {PPD benefits for unscheduled benefits. You will not receive permanent partial disability for injuries to the back, neck, head, spine, or teeth – with one exception.

 

You have a viable claim for PPD for unscheduled losses if the unlisted injury affects a scheduled member.

 

For example, a lower back injury often results in pain in the leg, and an upper back injury might cause shoulder and arm pain.

 

Therefore, you can pursue PPD for these limbs if you suffer an injury to the spine, back, neck, thorax, or abdomen. 

 

Can I Receive Compensation for Permanent Partial Disability in a Lump Sum?

 

Yes. 

 

Although Virginia uses a chart that assigns weeks of compensation for permanent loss of use of specific body parts, you can receive PPD in a lump sum. 

 

The question is whether you must agree to a four percent deduction to get a lump sum PPD award instead of weekly checks. 

 

If the number of weeks of PPD you qualify for has passed since your MMI date, you will receive permanent partial disability in a lump sum. 

 

If, however, the Commission enters the award of permanent partial disability soon after you reach MMI and the number of weeks of PPD owed has not expired, the employer may pay the benefits weekly unless you accept the four percent deduction.

 

Here is an example:

 

You reach MMI for a knee injury (torn ACL and meniscus) on January 1, 2023. 

 

Based on the disability rating, you will receive 26 weeks of PPD benefits. 

 

However, you wait to pursue your claim until January 1, 2024, when the claim administrator (Sedgwick) offers an award. 

 

In this scenario, you will receive a lump sum because more than 26 weeks have passed since you reached MMI. 

 

What is the Deadline to Claim Permanent Partial Disability Benefits?

 

The statute of limitations for your workers comp PPD claim depends on what other benefits you have received. 

 

You must file a claim for permanent partial disability within three years of the accident date if you only have an award for lifetime medical benefits. 

 

If you have received wage loss payments under an award, you have three years from when you were last paid under the award to file for PPD. 

 

The deadline for claiming compensation for permanent partial disabilities, however, does not mean you must prosecute your claim within that period. 

 

For example, those of you with catastrophic injuries resulting in the need for a total knee replacement or a lumbar spinal fusion may not reach MMI within three years of the accident. 

 

As long as you have filed a claim within the limitations period, you can reserve the right to seek PPD until you have reached MMI and received a disability rating.

 

When Should I Pursue the PPD Amount?

 

You may have heard the saying, “Timing is everything.”

 

This maxim applies to claims for compensation for PPD. 

 

Let’s look at two situations where you may question whether to pursue your PPD claim or wait. 

 

Permanent Partial Disability When Receiving Other Wage Loss Payments

 

Pursuing PPD as soon as you receive the MMI declaration, and an impairment rating is tempting. 

 

However, case law and regulations may prevent you from doing so. 

 

For example, you cannot receive TTD and PPD benefits concurrently. Therefore, you should not litigate the claim for compensation for permanent partial disabilities while you have an Award Order for temporary total disability. Instead, you should continue to receive TTD. 

 

This rule does not apply when you have an award for temporary partial disability. The Workers Compensation Act permits injured employees to simultaneously receive TPD and PPD benefits. 

 

In addition, I recommend waiting to seek compensation for permanent partial disability until you have returned to work for at least six months (if you return at all).

 

Returning to work might reveal additional problems with your recovery, resulting in a higher disability rating.

 

PPD When Surgery is Considered

 

Many of you have either had or will require surgery to heal your work injury.

 

Deciding whether to get an impairment rating and ask for permanent partial disability benefits before or after surgery is a big decision. 

  

Generally, I recommend getting a disability rating before undergoing a partial or total joint replacement. The law allows this under the rationale that the employer should not benefit from increased function due to the implantation of a prosthesis

 

High-Quality Attorneys for Permanent Partial Disability Benefits Payouts

 

Claims for compensation for permanent partial disability are rarely straightforward in Virginia. 

 

However, an experienced and skilled lawyer can help you get the maximum amount of permanent partial disability benefits available for functional loss of use from your work injury. 

 

We help injured employees obtain PPD settlement payouts by: 

 

• Consulting with your workers comp doctor to determine when you will reach MMI and whether you will have a permanent impairment

 

• Educating your physician on how the Virginia Workers Compensation Commission decides claims for PPD

 

• Ensuring the medical reports address impairment and disability to increase your chance of a large PPD payout 

 

• Negotiating PPD settlements when the medical evidence conflicts regarding the percentage of permanent impairment or which body part to rate

 

• Presenting your permanent partial disability claim at hearing, if necessary.

 

You have nothing to lose, and a lot to gain, by calling us for a free consultation: (804) 251-1620 or (757) 810-5614