Permanent Partial Disability Rating Workers’ Compensation Guide: How Virginia PPD Claim Ratings Work
A disability rating, also known as an impairment rating, is a number greatly affecting how much workers’ compensation you’ll receive for a permanent partial disability (PPD). Here’s how PPD ratings work in Virginia, described by some real life examples.
What is a Permanent Partial Disability rating in Virginia?
If your work injury has resulted in a permanent partial disability (PPD) and you want to get workers’ comp, you’ll need to establish the extent of damage on your body. A disability rating or impairment rating is a number that a doctor gives to signify how much permanent impairment each body part will have.
For instance, a healthy, uninjured leg will have an impairment rating of zero percent. But if your leg has been totally amputated, it means you’ve lost all use of that particular leg and it will have an impairment rating of 100%.
How does my PPD rating affect my workers’ comp in Virginia?
Your impairment rating is part of the calculation of your permanent partial disability benefits. Not only that, it’s the only variable number in the formula, meaning it’s the only number that may be changed. The other two elements in the calculation – your compensation period and your average weekly wage – are fixed. Thus, you’ll want to get a disability rating that truly captures the extent of your injury.
To understand this better, here’s the formula for computing your PPD benefits:
- Take 66 ⅔% of your average weekly wage.
- Multiply that by the number of weeks of compensation (outlined by the Virginia workers’ comp schedule).
- Multiply that by your impairment rating.
- The resulting number is the total amount of PPD benefits you may receive.
For example, let’s say you seriously injured your arm at work. Prior to your injury, you had an average weekly wage of $1,200. Take 66 ⅔% of that and you’ll get $800 – that’s step 1 of the computation. Next, according to the Virginia compensation schedule, the compensation period for an arm injury is 200 weeks. The doctor also gives you a disability rating of 50% or 0.5. Multiply these three numbers together to determine your PPD benefits amount:
$800 x 200 x 0.5 = $80,000
You can see how a bigger impairment rating can result in a bigger PPD compensation, and conversely, a smaller impairment rating can lower the PPD benefits amount. Work with a resourceful workers’ comp attorney who can connect you with trusted physicians and help you get the right impairment rating.
How do I get a Permanent Partial Disability rating in Virginia?
The process to get an impairment rating in Virginia starts with your MMI or maximum medical improvement. The MMI is the point in time when your health has reached all the recovery it can get after your injury. MMI means that further treatments can no longer make a significant difference in your condition. Once your treating physician declares that you’ve reached maximum medical improvement, you can seek out an impairment rating.
When you work with Attorney Jaleh Slominski, we’ll request your treating physician to provide your impairment rating. If the doctor is unable to do so, we’ll tap into our network of trusted doctors and get you an appointment for impairment evaluation.
You can expect that the workers’ comp insurer will ask you to undergo a separate functional capacity evaluation (FCE) to get a different rating. You’ll need to comply with the FCE to avoid jeopardizing your claim, but it’s wise to get your lawyer’s guidance before agreeing to anything.
How valid are PPD ratings?
A disability rating is crucial in proving your permanent impairment to the Virginia Workers’ Compensation Commission. It’s a way to quantify your impairment instead of just describing it in your own words. There are a few cases where the Commission may not need a rating to assess the disability, but in general, you’ll need your PPD rating for a strong workers’ comp claim.
Impairment ratings are commonly based on the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment. The AMA Guides are widely recognized as the standard, though some evaluators have commented that these guides may not be the most reliable system for rating impairments. Despite this, physicians, lawyers, and even the Workers’ Compensation Commission often use the AMA Guides.
Because there isn’t an official standard under the law, it’s possible to encounter disputes regarding your disability rating. Protect your best interests by having a workers’ comp lawyer on your side.
What if the insurance company disputes my disability rating?
It’s common for employers and workers’ comp insurance companies to disagree with a disability rating, especially when they consider it too high a number. The insurer might argue that your physician gave a biased rating that overstates your impairment. They may ask you to get another rating through an independent medical exam.
If you have multiple conflicting ratings, you’ll need to attend a hearing with the Workers’ Compensation Commission, ideally with a lawyer who advocates for you. The Deputy Commissioner will either average all your impairment ratings, or choose one of the ratings that they deem most accurate.
Who pays for me to get a disability rating in Virginia?
To get an impairment rating, you generally need to undergo an examination called a functional capacity evaluation (FCE). Your employer, through their workers’ comp insurance company, generally pays for your FCE.
This is a new rule in Virginia that came out of the 2021 case Kenneth Elliott v. Sam Green Vault Corporation. Prior to this case, the state had a longstanding law that employers are not responsible for paying for these evaluations. Today, however, you may be able to work with your attorney to advance these evaluation costs.
I injured my foot but the doctor gave me a rating for my lower extremity (leg). Is this right?
One consideration when getting a PPD rating is: If you injured one small body part, should you be rated for that specific part or for the entire limb? For instance, if your injury is on your foot or ankle, should you get a foot rating or a leg rating? The answer to this depends on the number of compensable weeks under the Virginia compensation schedule, and whether you can prove the extent of the injury.
Looking at Virginia’s compensation schedule, you’ll want to be rated for the body part or limb with the greater number of compensable weeks. If you injured your ankle, for example, you’ll see that the compensation period for an impaired foot is 125 weeks but for an impaired leg, 175 weeks. In this case, you’ll want to be rated for your leg impairment. If the injury has permanently impaired two or more body parts, you may seek a separate PPD rating for each.
You must, however, prove to the Commission that you’ve permanently lost some use of the body part (or parts) because of your ankle injury. Without a convincing case, the Commission may refuse to recognize the leg injury and may limit your claim to a foot injury only.
To assert your leg injury claim, it’s extremely helpful to have a lawyer who knows case law – someone who is familiar with previous case rulings that support your claim.
It’s also valuable to be rated by a trustworthy doctor who understands the true impact of your injury. Attorney Jaleh Slominski is connected with Virginia medical providers, and she can ensure you get a fair disability rating. She’s also deeply knowledgeable in Virginia workers’ comp case law, having served in the state for over two decades.
Can I get paid for a lower extremity rating?
Yes, each extremity or limb is compensable under Virginia workers’ comp law, as long as you have a disability rating greater than zero percent on that limb. According to the Virginia PPD schedule, a permanently impaired arm (upper extremity) gets up to 200 weeks of compensation, while a permanently impaired leg (lower extremity) gets up to 175 weeks.
Can I get paid for an impaired finger or toe?
Yes, Virginia provides benefits for permanently impaired fingers or toes. In fact, state law also specifically recognizes every phalanx (segment) of fingers and toes. Here’s an excerpt of the Virginia workers’ comp schedule showing their maximum compensation periods:
- Thumb – 60 weeks
- First finger (index finger) – 35 weeks
- Second finger (middle finger) – 30 weeks
- Third finger (ring finger) – 20 weeks
- Fourth finger (little finger) – 15 weeks
- First phalanx of any finger – half the compensation period for that finger. If more than one phalanx is impaired, the entire finger is considered impaired.
- Big toe – 30 weeks
- Any other toe – 10 weeks
- First phalanx of any toe – half the compensation period for that toe. If more than one phalanx is impaired, the entire toe is considered impaired.
Can I get a disability rating for scars or disfigurement? Can I get paid for it?
Yes, in Virginia, significant permanent scarring or disfigurement is considered an impairment even if it doesn’t stop you from working. However, the impairment rating for disfigurement will not come from a doctor but from the Workers’ Compensation Commission. Either the Deputy Commissioner or a Claims Examiner will evaluate whether the scar is “severely marked disfigurement.” If so, they’ll use their own discretion to give the scar a PPD rating.
In addition, you cannot get compensation for both scarring and loss of use of a body part at the same time – you must choose one. For instance, if a workplace accident permanently injured your arm and left you with a large scar there, you’ll need to decide whether to claim for the arm disfigurement or for the loss of arm function. Consult a lawyer to determine the best option for your workers’ comp claim.
Contact Jaleh K. Slominski – Virginia Workers’ Comp Lawyer
For over 20 years, Attorney Jaleh K. Slominski has been trusted by workers in Virginia for her skilled handling of workers’ comp cases. She tenaciously advocates for the best interests of employees, getting them the care of trusted medical professionals and asserting their rights opposite insurance companies. With her network in the medical community, she ensures each client gets a thorough and fair impairment rating, helping them get favorable comp awards.
Consult Attorney Slominski if you have concerns about your impairment rating or your workman’s comp claim in general. Call us at (434) 384-9400 in (Lynchburg) or (540) 554-3762 in (Roanoke).