09.19.2019 Written by: Henningson & Snoxell, Ltd.
What is PPD?
My clients frequently ask about a Permanency Rating or Permanent Partial Disability rating. Under the Minnesota Workers’ Compensation Act, an injured worker is entitled to a monetary benefit that compensates for the loss of use or function of a body part that is harmed due to the work injury. The Department of Labor and Industry developed guidelines for these ratings based on the extent of workers’ injuries. Chapter 5223 of the Administrative Rules lays out these ratings for each body part. Some injuries and conditions may not have specific correlating ratings, but a doctor may assign a rating based on a similar condition or injury under the Weber Rule. This rating is then multiplied by a monetary amount to determine the extent of the benefit.
How is PPD calculated?
For example, if an employee sustains a low back injury and the MRI demonstrates a herniated disc and the doctor determined that he needed a fusion surgery, the doctor would assign a 12% rating under Minn. Stat. 5223.0310, Subp. 4 (a); 2(a). The employee would be entitled to $10,200.
.12 (Rating) (x) $80,000 (factor set by the statute) = $10,200
This chart applies to injuries that occurred after October 1, 2018.
|Impairment Rating ______||Amount|
Who Calculates or Assigns a Permanency Rating?
Your doctor will assign a PPD Rating when asked by your attorney or the adjuster for the injury company. Generally, your lawyer will send a narrative request or the adjuster will send a Healthcare Provider Report or “HCPR.” If the insurer disputes the rating assigned by your treating physician than he or she may send you to an independent medical examiner or IME. If you dispute the amount given, if any, by the IME then you may file a claim petition for the disputed amounts.
When is PPD paid to me?
PPD is paid when you reach MMI or maximum medical improvement. MMI doesn’t mean that you are “cured” or healed 100%. MMI means that you are at the point in your recovery where your condition will not greatly improve or decline. You have reached a plateau. PPD benefits may be paid in a lump sum under statute or they may be paid out on the same schedule as TTD or temporary total disability benefits. If you request that your TTD be paid in a lump sum then the insurer may take a small reduction for present value, as they are paying you all at once instead of weekly installations.
Why haven’t I received a PPD Rating?
Because you didn’t know to ask. Frequently insurers will neglect to pay injured workers’ PPD benefits. Generally, adjusters are not in a hurry to send a HealthCare Provider Request to a physician, knowing that they will have to pay benefits. There are also advantages to waiting to get a permanency rating. If you are receiving ongoing TTD or temporary total disability benefits, then you are not at MMI. If you ask for a rating and are put at MMI, then your TTD ends 90 days post- MMI. Be careful what you wish for!
Do I need a lawyer?
If your doctor hasn’t assigned a rating or the insurer hasn’t asked for a rating, you may need a lawyer to step in. You also may need an attorney if the insurer disputes the amount of PPD in question. Essentially, if there is a dispute paying or obtaining a permanency rating you should consult an attorney. Furthermore, insurers and employers frequently dispute permanency ratings when there is a pre-existing condition. However, if there is no prior evidence in the form of a prior MRI, for the ratable permanency, then the permanency should be attributed to the new work-related condition. Additionally, injured workers may also have old work injuries for which they were never paid a PPD rating. If you have an admitted injury and have not entered into a full final complete stipulation for settlement, then you may be entitled to an additional PPD rating.
Contact Attorney Mary Beth Boyce at Henningson & Snoxell, Ltd. at (763) 560-5700 for a free, no-obligation consultation regarding your PERA/MSRS Duty Disability and/or workers’ compensation case for more information about the statutory requirements as well as the application process. Mary Beth is experienced in PERA and MSRS Duty Disability law and repeatedly successfully establishes entitlement to PERA and MSRS Duty Disability benefits for her clients injured in the line of duty.