What is a PPD award? May I negotiate with L&I for a higher amount?

By August 12, 2013Workers Comp

21by Kylee Redman

PPD stands for Permanent Partial Disability.  A PPD award is paid on cases where an injured worker will remain physically impaired as a result of their injury.  Permanent partial disability should only be addressed when your doctor says there is no additional treatment which will make you better.  If your doctor recommends additional treatment but the Department wants to close your claim, or if you are not back to work and the Department closes your claim, you should immediately contact our office.

In some cases, your injuries will have healed completely without any remaining problems or impairment.  In such a case, you will not be entitled to a PPD award.  The award is meant to compensate injured workers who have a permanent impairment as a result of their injury.  Unlike a car-accident lawsuit, injured workers cannot be paid for pain and suffering.  The PPD award compensates for measurable loss of function of the injured body part.

PPD is rated by a physician.  Your own doctor can provide the rating for your injuries.  If your doctor is unwilling to rate, however, the Department or self-insured employer will send you to a one-time examiner – a so-called “Independent Medical Exam” or IME – for purposes of getting rated.

Your doctor should have the opportunity to review and comment on any IME report.  It’s a good idea to meet with your doctor to review the report.  If your doctor agrees with the conclusions of the IME doctors, the Department will close your claim.  If your doctor disagrees, she should send a report to the Department explaining the basis for her disagreement.

The rating determines how much PPD you receive.  The PPD is based on the dollar value assigned to the different parts of your body.  The Department, by law, sets those values each year which are displayed in a chart, also called a “schedule,” and may be found on the Department’s website or by clicking here .

The cash value of your PPD award is determined by what body part was injured and the date of your injury.  The amount assigned to these body parts is the same for every injured worker who is injured during that year.  Therefore, you cannot challenge or negotiate the dollar amount of the award; you may only challenge or appeal the PPD rating.

If you have an injury to your spine or internal organs or if you have a mental health impairment, the rating will be given in terms of Categories.  For example, you may be rated Category 2 impairment for a low back injury.  Category 2 for your low back equals 5% of the value of your whole body.   Other types of injuries will be rated in terms of percentage of loss of function.  For example, you may be rated as having a 10% impairment of your shoulder.  That would be 10% of the value of your whole arm.  Again, both of these ratings would be based on the values in place at the date of your injury.

The Department or self-insured employer through their IME doctors frequently try to reduce or eliminate a PPD award, saying the disabling condition pre-existed the injury.  For example, most people have degenerative disc disease in their neck or back but have no pain.  The injury causes a worsening of that condition.  Any rating, then, should include the degenerative disease because it was not causing problems before the injury.

If you feel your PPD is incorrectly reduced, you should call our office.   We can help you obtain the highest possible PPD award on your claim.

If you have any questions about PPD ratings or awards, please contact us.

Kylee Redman is an associate attorney with The Walthew Law Firm.  Her practice includes workers’ compensation and personal injury law.