Permanent Partial Disability Rating Exams

April 3, 2023


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Permanent Partial Disability (PPD) ratings exams are how medical professionals determine how severe your workplace injury is and how it is rated toward the PPD award schedule. You’ll usually have a rating exam done by your primary physician, then an IME by an L&I-approved physician once you’ve reached maximum medical improvement.

What Is An IME?

An IME is an independent medical exam and may be required as part of your PPD workers’ comp claim. This exam is done by a doctor other than your primary care physician, with the examining doctor typically being chosen by L&I. The reason for requesting this exam during PPD cases is to get an independent, expert opinion on your medical condition and injury status.

This doctor will also rate your injury and its severity as part of your claim and send the information to your employer, L&I, and your primary doctor. An IME is not a medical treatment appointment. It should be considered more of an evaluation where the L&I-approved doctor gathers all critical information about your injury and how you are currently healing so they can provide a comprehensive rating.

How Does A Doctor Determine Lost Function Or Permanent Partial Disability?

To keep PPD ratings fair and consistent, doctors must follow the guidelines in the American Medical Association’s Guides to the Evaluation of Permanent Impairment.

These aim to be a comprehensive guide for any potential impairment workers may encounter, and doctors are required to consult these resources when determining ratings for PPD cases.

How Long Does It Take To Get A Permanent Partial Disability Settlement?

You can expect your workers’ comp PPD claim — from filing to settlement payment — to take anywhere from 12 to 18 months. However, the time can be shorter or longer depending on the specific details of your case and whether you work with an L&I attorney. Generally, PPD cases without legal representation tend to be resolved faster but with a lower settlement, while cases with a lawyer may take longer but have a better payout.

Your PPD award won’t be paid out until your case is completely closed, so you won’t receive any funds until then.

How Long Do Permanent Partial Disability Payments Last?

Your injury percentage rating, your income at the time of the injury, and which body part was injured help determine how long your workers’ comp PPD payments will last. For an injury rating of 50% or less, you can expect PPD benefits to payout for about 425 weeks or just over eight years. Any rating above 50% will have benefits for 520 weeks or 10 years. Remember that these percentages don’t affect PPD awards, which are paid out for the rest of an injured worker’s life.

How Do I Know If My L&I Settlement Is Fair?

Allowing L&I to decide what is fair is not in your best interest. Indeed, the PPD workers’ comp claim manager assigned to your case has a lot of discretion to categorize the severity of your injury or illness, which determines how much L&I will compensate. Since the claim manager’s job is to minimize costs, few workers ever get back everything they lose after sustaining a disability. The only way to ensure that you aren’t shorted by the system and get maximum PPD benefits is to seek expert legal help to fight for your interests.

Why You Should Hire An L&I Attorney

You may be hesitant to hire an L&I attorney because you’d rather tackle a workers’ comp PPD case alone. While you can go through the claim process by yourself, it can be challenging, confusing, and overwhelming to deal with while you’re also trying to recover from your injury. Instead, you should work with an expert L&I attorney who is experienced in PPD law, benefits, payments, and cases to ensure you get the best possible outcome for your claim.

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