Some claims for workplace injury or occupational disease are serious enough that surgery is needed. Others may involve a long recovery time for a variety of reasons. When either of these situations come up, the injured worker may be referred for an impairment rating to determine if they have a permanent partial disability (PPD).

PPD means that the worker has lost the use of some or all function in specific parts of their body. It is a way of recognizing that your employee has a disability now, but he or she is not totally disabled. L&I pays a financial award to the employee instead of a monthly pension because they are still able to work even with the partial disability.

 

Impairment Ratings

The amount of the award is decided by an Impairment Rating, in which an approved doctor (L&I maintains the list of providers who can rate) determines the amount of disability. Ratings can be assigned by percentage, which is used for the spine and many central body parts, or on a flat fee for each extremity that is affected. See the L&I Impairment Rating amounts.

There are also a few impairments related to procedures, such as meniscectomies (knee surgeries) and joint replacements. The handbook for ratings is known as the Physicians Guide to Permanent Impairments and, while some physicians may use the sixth edition, L&I only recognizes ratings that are based on the fifth edition.

No matter how the rating is determined, the corresponding dollar amount is paid to the injured worker as compensation for their partial disability.

 

Nurse and IME review of Impairment Ratings

The amount paid to the injured worker is charged against the claim, which can impact your company in the form of higher future premiums and lower retro refunds. That’s why Approach Retro Coordinators review each rating to ensure it’s consistent with the earlier progress of the claim.

If there’s any doubt, our on-staff Nurse Case Manager can review the impairment ratings for inconsistencies. Sometimes the report is simply unclear, while in other cases, as an example, pre-existing impairment is accidentally assigned to the new claim.

PPD and impairment ratings can provide closure for the injured worker by acknowledging the disability and providing compensation. Payments aren’t impacted by work status, so your employee can return to work without fear of losing compensation as a result. Our focus at Approach is to ensure that the ratings are applied correctly, so that your L&I account isn’t charged for any undue expenses related to this process.

 

Your Approach Retro Coordinator will let you know if your claim is subject to impairment rating. Or contact us if you have questions about a current or past claim.