If you have been injured on the job – especially if it’s for the first time – even the basics of Indiana Worker’s Compensation may seem confusing to you, so that’s why I want to talk a little bit about some terms your worker’s compensation insurance company may commonly use after you suffer an on-the-job injury. Today I want to talk about Permanent Partial Impairment, or PPI.
One of the most essential terms that will come up in just about every worker’s comp case is something called the Permanent Partial Impairment rating (PPI rating). Once a doctor determines an injured worker has reached maximum medical improvement (MMI) following a work injury, the doctor attempts to assign a number value to the permanent, partial, loss of function of the body or a body part. The higher the impairment, the higher the number. This is what a PPI rating is. PPI ratings are important to injured workers because they ordinarily serve as the #1 factor in determine what the dollar value of a worker’s compensation claim is to the injured worker.
Permanent Partial Impairment is not to be confused with disability: impairment deals with loss of function, while disability deals with loss of the ability to work. They often go hand-in-hand, but not always.
Not every injury warrants determination of a PPI rating, but some injuries result in very high PPI ratings. A good comparison to make is if you cut your finger, it will heal in a couple of days and everything will be back to normal. There will never be a PPI rating for something like that. But if you work in the healthcare field and you badly injure your back while lifting a patient, you have a surgery but your back still doesn’t get back to 100%, you are absolutely going to have a PPI rating.
PPI ratings are ordinarily measured as a percentage of the body as a whole. So, someone with a back injury and a 7% PPI rating is said to have a 7% permanent partial impairment to the body as a whole. Injuries to certain body parts must be assigned a PPI rating to that specific body part, and then “converted” to an impairment of the body as a whole. For instance, a 10% impairment to the wrist (which the Worker’s Compensation Act calls the “hand below the elbow” for some weird reason), translates to a 4% whole body impairment.
Injuries to certain body parts may be so severe that they result in an injured worker’s total loss of use of that body part. These are called “scheduled member” injuries, and a set formula is applied to determine your PPI rating. For instance, if you sustain a total loss of use of your right arm above the elbow, your PPI rating is set by law at 50%. Other scheduled members include the feet, toes, hands, fingers, lost vision and lost hearing. The Indiana Worker’s Compensation Board publishes a chart identifying the scheduled members and their values. If your total loss of use of a body parts is caused by an amputation (like a finger in an industrial accident), the PPI rating is doubled. If multiple amputations occur, the Indiana Worker’s Compensation Board has developed a formula to combine the ratings for each body part into one rating.
Impairment ratings are important in Indiana worker’s compensation cases because they are the primary thing that drives the settlement or hearing value of your worker’s comp case. For instance, imagine an upper back injury results in a 7% PPI rating. Currently, in the 1st half of the year 2020, each degree of impairment (up to the first 10 degrees) has a dollar value of $1,750.00, which is set by Indiana Worker’s Compensation law.
The dollar value for each degree of impairment increases depending on how large the impairment rating is. For ratings between 11 and 35 degrees, the value is $1,952.00; for 36-50 degrees, it’s $3,186.00; for anything above 50 degrees, it’s $4,060.00.
As you may know, in Indiana, the worker’s compensation company chooses your doctor. In my experience as a lawyer, most doctors provide good quality medical care, but the PPI ratings they assign tend to be lower than what I would see as reasonable considering my clients’ condition after being placed at MMI. It’s pure speculation, but one certainly wonders if doctors that do lots of worker’s compensation work feel pressured to issue low PPI ratings in order to keep receiving referrals from worker’s compensation insurance companies.
Although they do not always get it wrong, there are frequently circumstances where a PPI rating assigned by your worker’s compensation doctor is not representative of your true impairment. In that situation, Indiana workers may wish to consider hiring a doctor of their own choosing to perform a thorough physical examination and records review, and prepare a report providing his/her opinion regarding your true PPI rating. This report can be used as evidence at a worker’s compensation hearing, and if the judge agrees with your chosen doctor, you may receive a more favorable judgment.
Most worker’s compensation cases settle before a hearing, however. In my experience, obtaining our own expert’s report increases the settlement value of worker’s compensation cases.
Hopefully, after reviewing this article, you have a good understanding of one of the Indiana Worker’s Compensation basics – Permanent Partial Impairment (PPI). If you have any questions about this term, or any issue you have with worker’s compensation, contact us today. At Hewins Law Firm, the initial consultation is always free, and we don’t get paid unless you get paid.