Permanent Partial Disability (PPD) Settlement Amounts
Washington state law broadly defines Permanent Partial Disability (PPD) as physical or mental impairment arising from an injury that is fixed, lasting, and stable, and can’t be improved with further medical treatment. When your injury can be classified as a permanent partial disability, you are entitled to workers’ comp PPD benefits and compensation for damages.
Let’s look at the type of settlements you may be eligible for, how PPD ratings and benefits are calculated, what to do if you disagree with a PPD settlement, and why you should hire an L&I attorney to guide you through your PPD workers’ comp claim.
Types Of L&I Settlements
Workers who have been injured in the workplace can file an L&I claim for their workers’ compensation. Depending on various factors, you could receive three different types of settlements for your injury.
Permanent Partial Disability (PPD)
Permanent Partial Disability (PPD) is a one-time settlement paid to injured workers when their L&I claim is closed, and they can return to work again. The sum paid is based on the type and severity of the non-disabling injury.
L&I permanent total disability pensions are for injured workers who will never be able to return to work due to a severe or life-threatening injury. Pension settlements are paid out monthly, and the sum awarded is based on injury severity and potential wages lost for the rest of the worker’s life.
Claim Resolution Structured Settlement Agreements
A Claim Resolution Structured Settlement Agreement (CRSSA) is an L&I settlement option where all parties agree to close an injury claim for a specified amount. When agreeing to this settlement type, the injured worker exchanges all future benefits—except medical—for the payment.
Learn more about L&I settlement amounts and how to calculate your estimated award amount.
What Are Permanent Partial Disability Settlements?
Permanent Partial Disability means you have an impairment that didn’t go away after you recovered from a workplace injury or illness. Workers’ comp PPD settlements are monetary awards for injured workers who are able to return to work and do their jobs in a limited capacity. If your injury or condition prevents you from returning to work at all, please see our pension section.
Common Injuries That Cause Permanent Partial Disability
There are common workplace injuries that could lead to PPD, including:
- Back injury
- Cardiovascular or respiratory disease
- Carpal tunnel syndrome
- Hearing or vision loss
- Knee injury
- Musculoskeletal disorders
- Nerve damage
- Post-traumatic stress disorder (PTSD)
PPD cases can be filed for more workplace injuries than those included on the list above. An experienced L&I lawyer can help you determine if your injury qualifies for PPD workers’ comp.
How Much Money Can I Get In A Permanent Partial Disability Settlement?
The amount of a Permanent Partial Disability (PPD) award depends on a number of factors, including the date of your injury and the severity of your disability.
- The date of injury matters because L&I increases the amount of money paid for disabilities each year. The monetary settlement amount can be found in L&I’s Permanent Partial Disability schedules, and it should be calculated based on the date of your injury.
- L&I determines the “seriousness” of a disability based on disability ratings. Your PPD rating is established by medical professionals, usually an IME physician or your personal doctor. A rating may be changed by switching your medical examiner.
Use our L&I settlement calculator to estimate your award amount.
How Are PPD Settlements Paid?
If you are awarded a PPD settlement, the amount will determine whether you are paid a lump sum or in monthly payments.
Smaller Permanent Partial Disability settlements are paid as a lump sum. If the award is less than three times Washington state’s average monthly wage (at the time of injury), you will receive a check in that amount.
Medium-to-large settlements are paid out as a lump sum and in time-based payments. If a settlement is more than three times the average monthly wage in Washington state at the time of injury, a down payment of that amount is made. The remainder of the settlement is then disbursed in monthly installments based on your time loss compensation (at the time your claim closed).
When your PPD settlement is closed, the first payment must be paid within five working days of closure (from a self-insured employer) or without any delay, if the L&I department is the one who closed your claim.
L&I PPD Schedule Of Awards
The PPD Schedule of Awards breaks down potential settlement amounts based on body system category, category rating (1-9), and the percentage of total body impairment (TBI).
Body systems include:
- Cervical and cervical dorsal
- Dorsolumbar and/or lumbosacral
- Convulsive neurologic
- Respiratory with normal baseline spirometry on or after 3/1/94
- Air passage
- Air passage due to nasal septum perforations
- Loss of taste and smell
- Upper digestive tract, stomach, esophagus, or pancreas
- Lower digestive tract
- Anal function
- Liver and biliary tract
- Spleen, loss of one kidney, and surgical removal of the bladder with urinary diversion
- Upper urinary tract
- Additional impairment of upper urinary tract due to surgical diversion
- Bladder function
- Anatomical or functional loss of testes
Category rates are ranked one through nine, with one being the least severe and nine being the most. These PPD ratings also influence how much settlement you could receive for your injury, with higher ratings being paid more due to the severity of the injury.
The PPD award schedule can’t be changed because it is set based on the categories, rates, and the date of your injury. However, L&I releases a new award schedule yearly, so some information changes through each iteration.
Remember that this information may be confusing since it was written for doctors, lawyers, and judges. An experienced L&I lawyer, like those at Emery | Reddy, can help you understand the award schedule and how it could impact your workers’ comp PPD.
Permanent Partial Disability Settlement Calculator
If you’re wondering how to calculate Permanent Partial Disability settlements, you cannot do it on your own. Settlement amounts are already calculated based on the above PPD Schedule of Awards. Based on the location of the injury on your body, how severe it is, and when the injury happened, L&I will calculate your PPD settlement when it’s time to close your claim.
Your injury is rated as a percentage in its category and given a value of 1–9. The higher the number, the more significant your injury is, and your PPD payment is calculated from those numbers before your case is closed.
Let’s look at a basic example of a permanent partial disability calculator.
A worker was injured in 2015, and their injury was rated at 25% impairment of the arm below the elbow.
In 2015, this injury had a monetary value of $108,036.33, but the worker’s injury was only rated at 25%. So, their settlement would be 25% of $108,036.33, or $27,009.08, paid out in a lump sum or monthly payments.
It’s important to note that injury monetary values are non-negotiable and cannot be changed; however, they can change year-over-year when L&I updates its award schedule. Your doctor decides the injury rating percentage, and there may be some flexibility in getting this number adjusted if you have an L&I attorney on your side.
PPD Rating Exams
PPD rating 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.
Some chapters that might be used in workers’ comp PPD cases include:
- Chapter 3: Pain-Related Impairment
- Chapter 4: The Cardiovascular System
- Chapter 8: The Skin
- Chapter 12: The Visual System
- Chapter 15: The Upper Extremities
- Chapter 16: The Lower Extremities
- Chapter 17: The Spine and Pelvis
Each chapter gives detailed instructions on how a doctor is supposed to determine your PPD rating. With this info and the details gained from your IME, they will assign your injury rating and percentage or decide if you are fully recovered.
How Long Does It Take To Get A PPD 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 settlement 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 pensions, 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.
What If My Settlement Award Is Too Small?
Take action. Our legal team has over 15 years of experience appealing settlements and getting the best outcome for Washington workers. Don’t wait until it’s too late: call today for a free case analysis.
If I Already Cashed My PPD Check, Can I Still Request More Money?
Injured workers can ask for more money even after cashing a Permanent Partial Disability settlement check. But don’t wait: workers must appeal workers’ comp PPD decisions within 60 days of the closing order.
Will My Permanent Partial Disability Payments Cover My Expenses?
The best way to find out is to allow us to take a look at your case. Our expertise in these unique PPD cases allows us to process and assess your L&I claim with all relevant information. During your free consultation, we will take a number of factors into consideration and present you with your options. We will empower you with the information you need to make a decision that will result in the best outcome for your situation.
How to Disagree With An L&I Decision
Many people believe that L&I decisions are final, but that’s not always the case. You, your doctor, or your employer can protest or appeal a decision if you don’t agree with the final outcome. The written protest must be submitted to L&I 60 calendar days from your claim’s decision date; otherwise, the settlement decision is permanent.
Let’s look at how to protest or appeal L&I settlement decisions.
To protest your L&I worker’s comp PPD case, you’ll need to write a letter to the claim manager listed on your L&I correspondence. In this letter, you’ll need to include:
- Why you are protesting.
- The nature and date of the decision.
- Information from your doctors, such as your current medical condition and treatment programs, as well as your current prognosis.
Add your name and L&I claim number on each page of the letter to keep everything together and remember that you must send the letter within 60 days of L&I’s decision.
Finally, mail your letter to:
Department of Labor & Industries
P.O. Box 44291
Olympia, WA 98504-4291
L&I can modify, reverse, or reaffirm the decision after receiving your letter, which will be their final decision. However, if you still disagree, you can send an appeal to the Board of Industrial Insurance Appeals (BIIA).
You have 60 days to appeal a decision to the BIIA, and again, you must submit your appeal in writing.
The appeal should include:
- Details of the decision you are appealing.
- Reasons why you disagree with the decision.
- Current medical condition, treatment, and prognosis.
- Where you want appeal proceedings to happen.
- Your name, address, and phone number.
- Your name and claim number on every page.
You can mail your letter to:
Board of Industrial Insurance Appeals
P.O. Box 42401
Olympia, WA 98504-2401
Or deliver it in person at:
Board of Industrial Insurance Appeals
2430 Chandler Court SW
Olympia, WA 98504
The BIIA will send your appeal to L&I to reconsider their decision. If they don’t, BIIA will schedule an appeal hearing. You can also appeal directly to BIIA without protesting to L&I first, and the process will be the same.
Is An L&I Permanent Partial Disability Award Really A Settlement?
Technically, no. A settlement is an agreement between both parties after there has been a dispute in the PPD claim. Instead, this award is a PPD benefit payout from the Industrial Insurance Act. If you get to the end of your workers’ comp PPD claim without dispute, you will receive the payment benefit. If you have any disputes in your claim, what you are paid at the end will be a settlement.
How Do I Get A Better PPD Settlement?
If you want to improve your chances of getting better PPD payments, there are various ways to make this happen.
- Consider a pension over a PPD settlement if you can’t return to work.
- Be direct and firm with IME doctors, but don’t be rude. Make sure they have all the factual information to make the right decision and don’t let them dismiss you or push you around.
- Make sure you understand the claims process to the best of your ability.
- Stay on top of your medical treatments, appointments, and paperwork.
- Don’t try to tackle PPD cases by yourself. Hire an experienced L&I lawyer to help you navigate the process and ensure you get the maximum PPD benefits you deserve.
L&I Pension Vs. L&I Permanent Partial Disability
At the end of your workers’ comp PPD case, you’ll be awarded either a pension or a PPD payment. To determine which one you’ll get, L&I looks at how your injury and impairment affect your employment. If you can return to work, even in a limited capacity, or already have, you’ll get a PPD award. For injuries that lead to complete disability and unemployment, you’ll get a pension for the rest of your life.
How to Determine If You Qualify for PPD
To qualify for a PPD award, you’ll need to meet workers’ comp eligibility requirements, including:
- Being an employee.
- Working for a company that carries workers’ comp insurance.
- Getting injured or developing an illness on the job.
If you meet these requirements, you can file a PPD workers’ comp claim and receive treatment until you fully recover or reach maximum medical improvement.
Do You Need An L&I Lawyer To Get A PPD Settlement?
The legal team at Emery | Reddy, PLLC will help you make that decision by assessing your circumstances and walking you through your legal options. Call us today to learn how we can help you with your case. Our firm won’t take your case unless we believe your settlement can be improved—which is often (but not always) the case. Please remember to have your L&I claim number readily available.
All workers in Washington have a right to hire an attorney to assist with their L&I claim. In some PPD cases, injured workers can effectively handle their own claim. However, if you run into any problems or have any questions, you should speak to a professional. Here are three signs that indicate that you need to consult with a workers’ compensation attorney:
- You or your loved one suffered a severe injury.
- You have run into problems with your employer or L&I.
- Your workers’ compensation claim was rejected, or your benefits were denied.
If you are still unsure whether or not you need to hire a workers’ compensation attorney, ask yourself these questions:
- Are you being denied the medical care you need to treat your injury?
- Has L&I requested that you see an IME doctor?
- Do you understand everything happening in your workers’ comp PPD case?
- Do you feel overwhelmed facing this process on your own?
If you answered yes to any of these questions, we encourage you to contact our law firm. During your call, our team can review your case, answer your questions, and help you take action to maximize your L&I benefits.
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.
Here are a few reasons you should consider an L&I attorney for your PPD workers’ comp case.
We Understand The Process
After a workplace injury, you may not know where to start with a workers’ comp PPD claim. L&I attorneys have extensive experience with PPD cases and can help you get started right away instead of trying to learn the process by yourself before you begin. After all, the sooner you file your claim, the sooner you can close it and get your PDD award.
We Prepare Claims Effectively
Workers’ comp insurance companies have strict requirements and processes for filing a PPD claim. If the process isn’t followed correctly or your claim is missing critical information, the case could be denied before it gets started. An L&I attorney knows exactly what information is needed to present a case and all the timelines to follow. With an effectively prepared claim, your PPD case will start more smoothly and can move forward with minimal complications.
We Understand The Workers’ Comp Insurance Industry
PPD law, insurance requirements, and industry regulations can be challenging to understand if you don’t know the ins and outs of each. And claims can be denied or come back with lower compensation when people don’t know how the industry works. With L&I attorneys on your side, you have people who understand workers’ comp insurance and are ready to negotiate and fight for you to get your maximum PPD benefits.
How Your Permanent Partial Disability Settlement Works
Once you’ve gone through the claim process and have reached the settlement phase, this is how it will work.
- With your approval, your L&I attorney will draft a demand letter listing your required settlement amount and send it to the workers’ comp insurance company.
- The insurance company can accept or counteroffer your settlement amount. If they counteroffer, you will move on to negotiations.
- You, your lawyer, and the insurance company will continue negotiating until you all agree to a satisfactory settlement.
- Once the settlement agreement is set, you’ll start receiving your payments or lump sum within a few days.
Get the Compensation You Deserve
When you’ve been injured in a workplace accident, the last thing you want to do is battle with workers’ comp insurance when you should be focused on your healing. Instead, hire an Emery | Reddy L&I attorney to guide you through your workers’ comp PPD case and help you get the compensation you deserve.
A workplace injury can derail your life, but it doesn’t have to. At Emery | Reddy, we fight for workers like you, ensuring we protect your rights, help you through the claim process, and get you the maximum PPD benefits for your injury.
Call us today for your free case review. Please remember to have your L&I claim number readily available.