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Workers’ Compensation and Permanent Partial Disability Benefits Explained by a Lawyer

 

Atlanta workers' compensation attorney

Under Georgia’s Workers’ Compensation Act, there are three types of permanent partial disability (PPD) benefits:

  • Loss of a specific scheduled member (e.g., the worker loses a thumb);
  • Loss of use of a specific scheduled member (e.g., the worker’s thumb is crushed and it is essentially non-functioning); or
  • an impairment to the body as a whole.

When an injured worker reaches "maximum medical improvement" or (MMI), the authorized treating physician (ATP) opines that the employee has recovered as well as they ever will for the injuries. The ATP will then perform a disability evaluation to determine the employee’s PPD rating.

In order for a worker to have an injury that qualifies for PPD payments, it has to be “disability partial in character but permanent in quality resulting from loss of use.” Georgia uses the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 5th Edition.

When the ATP performs the disability evaluation, they will assign a percentage of impairment according to the AMA Guides®. For example:

The injured worker severely injures their shoulder requiring them to undergo surgical repair. Post-surgery, they actively participate in physical therapy to regain some strength, range of motion, and flexibility in the shoulder. However, despite the ATP’s best efforts, as well as the injured worker’s, they will never regain 100% of their shoulder. The doctor must perform a PPD evaluation using the AMA Guides® to determine the employee’s percentage of disability.

The ATP might assign the following:

  • 15% PPD rating to the Upper Extremity
  • 7% PPD rating to the Body as a Whole

Based upon this PPD, the employer/insurer must pay an additional sum of money to the injured worker.

Please note: The employer/insurer are not required to pay PPD benefits to the injured worker as long as they are entitled to Temporary Total Disability (TTD) or Temporary Partial Disability (TPD) benefits for the accident in issue.

Georgia has a “schedule” or list that sets forth the number of weeks benefits must be paid for the total loss or loss of use of various parts of the human anatomy:

 

Bodily Loss Maximum Weeks
Arm
Leg
Hand
Foot
Thumb
Index Finger
Middle Finger
Ring Finger
Little Finger
Great Toe
Any toe other than the great toe
Loss of hearing (one ear)
Loss of hearing (both ears)
Loss of vision of one eye
Disability to the body as a whole
225
225
160
135
60
40
35
30
25
30
20
75
150
150
300

 

Under the AMA Guides®, impairment ratings to the neck, back or spine must be stated as a whole person impairment rating.
Continuing with the above example, the PPD would be calculated as follows:

Assume the injured worker’s TTD rate was $525. The PPD calculation would be as follows:

  • 15% to the UE x 225 weeks x $525 = $17,718.75
  • 7% to the BAW x 300 weeks x $525 = $11,025.00

The injured worker would be entitled to the higher of the two ratings. In this example, they would choose the 15% to the UE as it equals $17,718.75.

There may be accidents where a worker sustains injuries to multiple body parts and the ATP assigns a series of PPD ratings. The Georgia Court of Appeals has ruled that under these circumstances, the injured worker is entitled to an award of PPD benefits for each of these PPD ratings.

This is Part 3 of the Georgia Workers’ Compensation Benefits series.
Part 1: Workers’ Compensation and Wage Benefits Explained by a Lawyer
Part 2: Workers’ Compensation and Medical Benefits Explained by a Lawyer

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