Sometimes, a conversation with a workers’ compensation insurance adjuster sounds like a bunch of gibberish. “PPD” is one of the most commonly used terms in an average North Carolina workers’ compensation claim. It sounds complicated, and your insurance adjuster may throw it out there just to confuse you. Really, PPD is straightforward, once you know the law:
PPD = Permanent Partial Disability
Perhaps the worst part about the term “PPD” is that it goes by so many names. Technically, it stands for “permanent partial disability,” but just to make sure you are super confused, the adjuster may also call it “permanency rating,” “impairment rating,” “97-31 benefits,” or “perm partial.”
What is it? Most sick and injured workers never make a full recovery. So, in a nutshell, the PPD rating is a number assigned by a doctor to indicate whether, and to what extent, you likely will have permanent problems with the affected body part. The PPD is usually expressed in terms of a percentage, such as “10% PPD to the foot” or “15% PPD to the arm,” and the doctors use special guidelines from the North Carolina Industrial Commission when they assign the rating. The number assigned is then plugged into a mathematical formula using your pre-injury wages to determine how much you are owed.
PPD ratings vary by doctor
One huge mistake injured workers without attorneys often make is to agree to accept a PPD payment without knowing his or her options. Two things often trip them up. First, the North Carolina Workers’ Compensation Act allows the injured worker to request a free second-opinion evaluation by a doctor of his or her choice. This means the first assigned PPD rating is not necessarily the one and only PPD rating. This also means that an injured worker who fails to exercise his or her legal right to a second opinion may be leaving money on the table. Although doctors must use guidelines to assign a PPD rating, the standards are somewhat subjective, meaning a second opinion with a good-choice doctor may yield a much different number.
PPD ratings vary by compensation rate
Second, because the PPD payment amount depends on a mathematical equation containing the worker’s weekly compensation rate, the payment amount is often incorrectly calculated. In order to determine if the PPD payment is correct, the worker must make sure 1) that at least two doctors have chimed in about the amount of the rating, and 2) that the correct compensation rate is used to tabulate the ultimate payment. The adjuster may send a Form 22 wage chart to justify whatever compensation rate used but be careful! Often, (for example, if the worker has not worked with the employer for a full year or is a seasonal or part-time worker), the Form 22 is not the best way to calculate the compensation rate. In many cases, an experienced workers’ compensation attorney can use another method and justify a compensation rate significantly higher than the one stated by the adjuster. This higher number, plugged into the equation, may yield a bigger check for you.
Don’t let acronyms fool you into thinking the adjuster’s number is necessarily correct. PPD is simple, but only if you understand your rights and options. If you have been assigned a PPD rating and wonder if it is correct, contact an attorney at Ricci Law Firm to help you understand what it all means.
Workers’ Compensation Lawyer serving Greenville and Raleigh
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