Permanent Partial Disability Benefits

ladderIn a Maryland Workers’ Compensation claim, the final benefit you should receive is called “permanent partial disability benefits.” If you are reading this post I have probably asked you to look at it to better explain what is going to happen in your case from this point on.

Some people talk about their workers’ comp “settlement.” This final step I discuss in this post is usually what they are talking about.

But it is not exactly the same thing as a settlement. A full & final settlement is a technically a different animal we will discuss later. 

Permanent Partial Disability (PPD for short) is the legal name given to this particular workers’ comp benefit. Everyone with a valid workers’ compensation claim gets this benefit.

Do not confuse this benefit with being truly permanently disabled, in the way most people think when they hear that word. It does not mean you cannot ever work again. This is just the workers’ comp term for the amount of money you get at the end of your case to compensate you for being somewhat less employable than you were before the accident. 

The Process of getting PPD benefits

Here is the short form version of the process:

We are going to get a rating of your permanent disability from a doctor. The insurance company will also get their rating from their doctor. That means you have to see two more doctors for your claim. 

The Maryland Workers’ Compensation Commission decides what the final result is after a hearing. The hearings are explained in detail here.

The final result is usually a compromise between the two ratings. The final number is then plugged into a very complicated formula set out in the law. That formula results in a certain amount of money designed to compensate you for your level of permanent disability. See below for more about how the payments work. 

Here are the detailed steps to getting PPD:

  1. You must be at “maximum medical improvement.” This means the doctor has released you from his or her care completely. This is not the same as being released back to work. It means you are as good as you are going to get, and you only need to see the doctor back as needed. 
  2. We must obtain your last medical records. There is always at least one last record that says you are at maximum medical improvement. We need that record. It tells us what, if any, level of permanent disability you have. We will always need to order it, and it may take 30 days or more to get it. (I hope not, but be prepared for that. Getting medical records is a real hassle due to the well intentioned, but poorly implemented, Federal HIPPA law.)
  3. After we get your last records, we will schedule you for a PPD rating from a doctor we hire. We will notify you of the appointment, and you will have to take time off to go. You can change the appointment if it is not convenient. 
  4. After you see the doctor, I will get a report that details your level of permanent disability, and assigns you a percentage loss of use of the affected body part. That usually takes 30 days or so after your appointment.
  5. When I get the report, I will file for a hearing at the Workers’ Compensation Commission. They will set a hearing date automatically, and you will get notice by mail. I will send you additional notices as well. It could take 3 months or more before the hearing is actually held.
  6. After we get notice of the hearing date, the insurance company will send you to their doctor for a rating. This is called an IME (Independent Medical Exam) and is the subject of a completely different post. I will send you more information about it when it happens. 
  7. We will either have a hearing before the Workers’ Compensation Commission, or we will settle your case. If we settle, it will usually be only a couple of days before the hearing. That is just how the insurer’s work!

How the Payments Work

As I mentioned above, the way payments are set is very complex and goofy. I will explain it in detail in this section. 

That rating will translate into a certain sum of money based on the workers’ comp statute. It is sort of complicated, but it works to give you a sum of money for your permanent partial disability.

(I will be happy to explain this formula in excruciating detail if you like, but it is goofy and weird and doesn’t make a lot of common sense.)

The important thing to know is that your award will call for you to be paid X amount of dollars per week for X number of weeks. The award is not necessarily paid in a lump sum, but sometimes it turns out to be that way. (Warning: This is where it gets goofy and complicated!)

The payments ordered in your award will start on a certain date. They are usually backdated to the last date you ever received a payment from the insurance company. If that last payment was some time ago, then you will get one lump sum “catch up” check for all the payments due between the date of your last payment and the date your Order comes out.

Sometimes, your last payment has been so far back that all the payments are due and payable on the day the Order comes out. If this is the case, you will get it all in one lump sum check. If not, you will get one check catching you up to date, and weekly checks in the future until the award is paid in full.

Here is an example to make that clear: Assume you get an award which calls for you to be paid $150 per week for 26 weeks, starting on January 1. You will be paid a total of $3,900 in weekly payments until July 2 (which is 26 weeks after January 1), at which time your payments will cease.

If this Order comes out March 1, you will get one lump sum check for all of January & February’s weekly payments, and the rest of the payments will come weekly until the Order is paid in full. If the Order comes out September 1, then you will get one lump sum check for all of the payments due.

If you are continuing to receive weekly checks from the insurer up to the date of our upcoming hearing, then you won’t get any money in a lump sum after the order comes out. There will be no time period to catch up. Your weekly payments for permanent partial disability payments will just continue into the future after your hearing until they are completely paid out.

And please note for accuracy, the attorney’s fees come out of your award and reduce the actual number of weeks you get paid. So, if you get that 26 week award in the example, my fees will be 20%, and that will be about 5 weeks of the total, then you will really only get 21 weeks of payments. The 5 weeks worth that pay the attorneys fees come off the back end. That is how the attorney’s fees are paid in workers’ compensation claims.

Yes, this is complicated. It is just how workers’ comp is. This is why most attorneys don’t handle these cases because it makes their heads spin. Read that section again, and call me if you have questions.

Conclusion

As you can see, there is a lot of waiting during this process. It may take 6 months to get through it.

I wish that were not true, but such is the pace of the Maryland Workers’ Compensation Commission these days. Most of this waiting time is out of my control. We wait for the medical records thanks to HIPPA. We wait for the doctor’s report. We wait for the hearing to be set by the Commission.

It can be an exercise in patience. 

But don’t worry! We have done it countless times and we will get there in the end. If you have any questions or concerns after reading this, please feel free to call me.

Next Steps

Want to know more? Discover what you need to know about workers’ compensation in Maryland. Click here to see our Free Legal Consumer Guide to Maryland Workers’ Compensation and get answers to your questions today. Know your options. Be informed. Protect yourself.

Need a workers’ compensation attorney? Please contact us for a consultation today if you need an experienced workers’ compensation lawyer in Waldorf and Lexington Park for your legal case.

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