Sometimes employees make a full recovery from on-the-job injuries. However, other workers may be left with a permanent impairment. When they can still work in some capacity, they may be eligible for permanent partial disability benefits from Virginia’s workers’ compensation system.
Whether you have suffered an on-the-job injury or not, there are several things you should know about these benefits, including:
- When employees may be eligible
- How much compensation may be provided
- When to file a claim
- Proving a disability resulted from a work injury
Virginia workers’ compensation claims are often complex, so it may benefit you to seek legal help from a licensed attorney with a track record of success. At Geoff McDonald and Associates, we have obtained millions in compensation on behalf of injured employees. CEO and President Attorney Geoff McDonald is a board member with the Workplace Injury Law and Advocacy Group.
Our Richmond workers’ compensation attorneys are ready to take your call today.
What Are Permanent Partial Disability Benefits For?
If you suffered a work-related injury that caused lasting impairment or restricted your ability to work in the same capacity as before, you may be eligible for permanent partial disability (PPD) benefits.
Virginia allows employees to receive these benefits for different types of work-related lung diseases, such as byssinosis or pneumoconiosis, injuries that resulted in the amputation of a body part, loss of use, scarring or disfigurement of certain body parts.
According to § 65.2-503 of the Code of Virginia, permanent partial disability benefits may be awarded for the loss of:
Employees may also receive benefits for a severely marked body disfigurement caused by an injury that is not mentioned in the Virginia workers’ comp code.
Can I Receive PPD Benefits for Head, Back, Neck, Brain or Spinal Cord Injuries?
These injuries are not listed in the Virginia code, but you may be eligible for PPD benefits if one of these injuries causes permanent disability for a body part that is listed. For example, if your spinal cord injury causes paralysis in one of your legs, you may be eligible for benefits.
When do Employees Become Eligible for PPD?
Benefits are not awarded until you reach the point of maximum medical improvement (MMI). This is the point when there is no reasonable expectation that you will see further functional improvement, even with continued treatment. If you reach this point and are still disabled, you may be eligible for benefits.
The burden of proof for maximum medical improvement is on you and your attorney. Virginia’s Workers’ Compensation Commission (WCC) evaluates the medical evidence and your treating doctor’s opinion to make its decision.
The WCC can determine you have reached maximum medical improvement even if you need surgery in the future. The surgery might not even be scheduled yet.
Future surgery is often necessary when workers suffer injuries such as:
- Herniated discs
- Back injuries
- Knee injuries
- Neck injuries
- Spinal cord damage
- Shoulder injuries
How Much Compensation Could I Receive for a Permanent Partial Disability?
Virginia has a scheduled loss system for awarding permanent partial disability benefits. Employees who are approved for benefits receive 66 and two-thirds percent of their average weekly wage. Virginia has a schedule setting the duration of benefits for each injury that qualifies for benefits:
- Leg – 175 weeks
- Arm – 200 weeks
- Hand – 150 weeks
- Foot – 125 weeks
- Loss of vision in one eye – 100 weeks
- Loss of hearing in one ear – 50 weeks
- Thumb – 60 weeks
- Index finger – 35 weeks
- Middle finger – 30 weeks
- Ring finger – 20 weeks
- Pinky – 15 weeks
- First phalanx of either thumb – half the compensation that would be paid for the loss of an entire thumb or finger
- Big toe – 30 weeks
- Any other toe – 10 weeks
- First phalanx of a toe – half the compensation for loss of a full toe
- Severely marked disfigurement of a body part – no more than 60 weeks
- First stage of pneumoconiosis – 50 weeks
- Second stage of pneumoconiosis – 100 weeks
- Third stage of pneumoconiosis – 300 weeks
- Byssinosis – 50 weeks
How Do I Prove a PPD Claim?
Often, injured employees must be assessed by a physical therapist specializing in functional capacity evaluations. You can then have your attorney talk to the therapist about signing off on a disability rating.
You must also prove you cannot use the injured body part like you could before. Often, this requires testimony at a workers’ compensation hearing or through an affidavit that describes the ongoing problems caused by your injury.
What is a Disability Rating?
The Workers’ Compensation Commission must decide on your disability rating once you reach the point of maximum medical improvement. This is a rating of your percentage of incapacity or lost function.
It is generally best to use the American Medical Association Guides to the Evaluation of Permanent Impairment to determine this rating. However, the WCC does not have to comply with these or other published guidelines when setting an impairment rating.
The information you and your attorney provide will be critical in the WCC’s determination of your disability rating and whether you are eligible for PPD benefits.
What is the Deadline for Filing a Claim?
If you were only awarded medical benefits but not temporary total or temporary partial disability benefits, you have three years from the date of your accident to file a claim for permanent partial disability.
If you received wage loss payments as part of an award agreement, you have three years from the date you last received wage loss benefits to file a claim for PPD.
However, it is best not to wait to file a claim. You should file for PPD benefits when you first file your workers’ compensation claim. Your attorney can ask the WCC to not refer your claim to the hearing docket until you reach the point of maximum medical improvement.
What if an Employer or Insurance Carrier Tries to Hold a Hearing Before You Reach MMI?
You are not eligible for PPD until you reach maximum medical improvement. If a hearing is held before you reach that point, your claim is going to be denied. If a hearing has been requested, you should consider hiring a lawyer to represent you. A lawyer may be able to reschedule your hearing, so you have a chance of being approved for benefits.
What Happens if Your Employer and its Workers’ Comp Insurer Dispute Your Impairment Rating?
Workers’ compensation insurers are likely to disagree with the impairment rating set by the medical examiner your lawyer sends you to. This may result in the insurance company sending you for an independent medical examination. The doctor they refer you to may very likely give you a much lower impairment rating.
When these disputes arise, you will need to attend a hearing before the WCC deputy commissioner. This hearing can have one of two outcomes:
- Take the average of both impairment ratings to determine your final impairment rating
- Select one of the impairment ratings as your permanent impairment rating
Call Today with Your Workers’ Compensation Questions
Our firm is ready to take your call anytime, 24/7. The initial consultation with one of our licensed attorneys is free, and you are not obligated to retain our firm. We also are not paid unless you receive compensation. There is no risk is talking to us about your claim and finding out how we may be able to help you.