Compensation for a permanent disability. Once a doctor has done all he or she feels can be done medically to help you, and you are not as physically able as you were before the injury, then you have a disability. And if there isn't anything else the doctor can do to make you any better, your disability will be "permanent," meaning you will suffer the effect of the injury from that point on. That disability will either be "total" meaning you are unable to perform any work, or "partial" which means you are able to work but there are limitations or restrictions as to what you are able to do. If you are determined to be permanently and totally disabled, your benefits will continue for the rest of your life. If your disability is a permanent partial disability (PPD), the legislature has established a formula to convert that disability into a dollar amount. The maximum weekly wage amount for a permanent partial disability is less than the maximum for the temporary total disability because the disability is partial instead of total. Compensation is for the disability only. The law does not provide compensation for pain and suffering.
Q My employer wants to settle my case, what should I do?
A. If your employer, or the insurance company, wants to settle your case, you should have finished medical treatment and have been released to return to work by the doctor. If you have not finished medical treatment, have recently had major treatment such as surgery or if you are still on work restrictions, your case is not ready to settle. If the work restrictions are permanent, the doctor should have advised you of this.
The disability benefit that is paid for any permanent residual effect of your injury is called permanent partial disability. This is a lump sum benefit that is paid to you after the injury has been treated and you have recovered to the fullest extent possible. The permanent partial disability benefit, often called PPD, is paid to compensate you for that permanent residual effect of the injury. These payments are based on a weekly schedule for various body parts, the rating of that permanent injury and your average weekly wage.
In order for your case to be settled, the doctor should rate your work-related injury. This rating is the doctor's opinion on the permanent effect of the injury. It is usually given as a percentage of a body part such as an arm, leg or finger. A back or neck injury is rated as a body as a whole injury. Depending on the body part affected by your injury, there are a number of weeks that are set out for that body part. For example, the leg at the hip is rated at 207 weeks, the arm at the shoulder at 232 weeks, the index finger at the first knuckle at 45 weeks, and the body as a whole at 400 weeks.
Your compensation rate is calculated the same way as the temporary total disability benefit, that is two-thirds of your average weekly wage. However, the maximum limitation is lower at 55 percent of the State Average Weekly Wage, or since July 1, 2003, $347.05. The maximum amount is determined by the date of injury.
Your average weekly wage is computed based on your gross wages. If your wages are fixed by the month, multiply your monthly gross wages by 12 and divide that total by 52 to determine your average weekly wage. If your wages are fixed semimonthly, multiply your gross wages by 26 and divide that total by 52 to determine your average weekly wage. If your wages are fixed weekly, that is your average weekly wage. If your wages are fixed by the hour, or some other method such as sales output, take a total of your gross wages for the last thirteen weeks and divide that total by thirteen to determine your average weekly wage. If none of these situations apply to you, please call (800) 775-2667 during business hours, 8 a.m. to 5 p.m. Monday through Friday, for further information.
Let's work through an example. Assume you have an injury to your wrist. The wrist is rated at the 175-week level. So if the rating is 10 percent, your settlement will be based on 10 percent of 175 weeks or 17.5 weeks. Assume your average weekly wage is $300.00. Your compensation rate (two-thirds of your average weekly wage) is $200.00. The compensation rate of $200.00 times the 17.5 weeks comes to $3,500.00. The total PPD benefit would be $3,500. Of course, an administrative law judge is the final decision maker on the appropriateness of the rating and the average weekly wage. So, just because the employer or insurance company has offered a settlement proposal, this does not mean your case is settled. You must appear before Division staff for final approval of the settlement.