My doctor gave me two impairment ratings for the same body part. Which one applies?

It is not uncommon for an ATP to assign two separate PPD ratings pertaining to the same body part. For example, if you injured your shoulder, you physician may assign a 15% impairment rating to your shoulder and a corresponding 7% impairment rating to the "whole body." In situations like this, the rating which yields the highest number of weeks of payable benefits is the applicable impairment rating.  This is an extremely important thing to remember when discussing a potential settlement of your claim.

In this example, the 15% shoulder rating would be used to calculate the number of weeks that PPD benefits are payable, because it yields 33.75 weeks of benefits, compared to 21 weeks for the 7% "whole body" rating. As you can see, this would make a huge difference in the total amount of PPD benefits you receive! For more information on how PPD benefits are calculated, please look here.

It's important to note that this post only pertains to those situations where the impairment ratings relate to the same body part. In other words, the rules are different if you suffer an injured leg and an injured arm in the same work accident, and your doctor assigns separate ratings for each of those body parts.

Quick Definitions: "Impairment Rating"

Also sometimes called a "PPD rating," this is the percentage of impairment that the ATP assigns to the specific body part that was injured in a work accident, or to the body as a whole. It is usually assigned towards the end of your treatment. This rating, which must be based upon the American Medical Association's Guides to the Evaluation of Permanent Impairment (5th Edition), is used to calculate your entitlement to PPD benefits.

Quick Definitions: "PPD Benefits"

PPD is the abbreviation for Permanent Partial Disability.  This is one of three types of weekly benefits that may be payable after a work accident.  PPD benefits are designed to compensate the injured worker for the permanent physical impairment sustained to a particular body part or the body as a whole as a result of a work injury. They are based upon a percentage of impairment, or impairment rating, that your ATP assigns to your injury.

For more information on PPD benefits, please look here. To compare to the other two types of weekly benefits, TTD and TPD, please look here, here and here.

Overview of Permanent Partial Disability (PPD) Benefits

When are they payable?

As I discussed in a previous post, there are three types of weekly benefits that may be payable to an injured worker after a work accident.  The previous post focused on TTD and TPD benefits, which are payable if the injured worker has suffered a disability due to his or her work accident. The third type of benefit, commonly abbreviate as "PPD," is only payable after the injured worker is no longer receiving TTD or TPD benefits. In other words, if you're currently receiving either TTD or TPD benefits, you cannot also receive PPD benefits at the same time.  

What is the purpose of PPD benefits?

Before I go any further, it's important to note the different purposes the three types of benefits serve under the law. While TTD and TPD benefits are paid to injured workers to compensate them for their diminished earning capacity due to the injury (loss of income), PPD benefits compensate injured workers for (1) the entire loss of a body part; (2) the loss of the use of a body part; or (3) the impairment to the injured worker's "body as a whole."

How is the amount of PPD benefits determined for each injury?

This can get a little complicated, so I'll try to keep this brief. The amount payable for a particular injury is based upon a percentage of impairment (often called an "impairment rating" or "PPD rating") which is assigned by the authorized treating physician ("ATP") to a particular body part or the "body as a whole." To determine the percentage of impairment, the ATP is required to consult the American Medical Association's Guides to the Evaluation of Permanent Impairment. For example, if you've injured your arm, the ATP will apply his knowledge of your treatment and your current condition to the AMA Guides and determine the percentage of impairment, such as 15%.  This percentage is then matched with the number of weeks assigned to each body part by Georgia law, which ranges from 20 weeks for a toe injury to 300 weeks for a back or whole body impairment.

For our example, the law states that you could receive up to 225 weeks of PPD benefits for the impairment of an arm (if you lost the arm completely, you would receive 225 weeks of PPD benefits). For a 15% impairment rating, you would be entitled to 33.75 weeks of PPD benefits (this is 15% of 225 weeks).  One more thing--the precise dollar amount of an injured worker's weekly PPD benefit, just like TTD or TPD benefits, is determined by the worker's compensation rate.