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Permanent Partial Disability claims: Get what you’re entitled to

By February 1, 2022April 3rd, 2023Worker’s Compensation
Permanent partial disability

A settlement is an official agreement intended to resolve a dispute or conflict. Often this means that although you do not get everything you are entitled to, you will be compensated sooner. On the other hand, Permanent Partial Disability (PPD) is the amount you are entitled to because you were injured on the job and can’t do what you once could with that body part. If any, the amount you will receive is calculated by a rating exam, referenced against a table of values, which varies depending on when you were injured and the injury’s severity.

Permanent Partial Disability claims

It’s unfortunate, but an injured worker usually has to fight to receive their PPD. *eye roll* Often they are sent out to an Independent Medical Examiner (IME) where the doctor sees you for only a few minutes, but doesn’t see the entire picture.

Some attending physicians refuse to do rating exams; however, those who do have a better understanding of an injured workers’ medical situation and may therefore be able to give you a more thorough exam. When your doctor determines your injury or condition has reached maximum improvement, they may be willing to do your rating exam.

Claim Resolution Structured Settlement Agreements (CRSSAs)

Though Permanent Partial Disability may get coined a “settlement,” they typically don’t require a bargained-for exchange that would involve a significant amount of “give-and-take” the way a settlement in a civil matter would. A prime example of this would be when an auto insurance company settles an issue with an injured person rather than going to trial.

Claim Resolution Structured Settlement Agreements (CRSSAs) are much closer to the concept of a settlement, but they aren’t available on every claim. For starters, a claim must have been open for a minimum of 180 days, and the injured worker must be at least 50 years old (although this number can change).

Better than nothing?

In the CRSSA scenario, the Department of L&I will calculate likely and potential costs associated with a claim. Then, they make an offer to settle the claim for an amount lesser than the potential costs. This offer is usually made contingent upon claim closure. The injured worker can then counter or negotiate a higher amount or other caveats to the agreement. All CRSSA’s must be approved by the Board of Industrial Insurance Appeals.

While CRSSAs can be valuable tools, in our experience, they are often not the best choice for the majority of our clients. One of the main reasons for this is that once a CRSSA has been finalized, no further monetary benefits will be paid on the claim, even if circumstances would otherwise entitle the injured worker to more. *screams internally*

Wherever you are in the process, consider the benefit of working with an informed advocate who knows every advantage and pitfall to guide you toward the best outcome.

Eastern Washington workers’ compensation lawyers

If you have a PPD claim or the Department of L&I has reached out to you about a CRSSA, contact Carlisle + Byers to schedule a free consultation with a dedicated workers’ compensation attorney.

*The foregoing does not constitute legal advice, nor does it form a lawyer-client relationship between the reader and Carlisle + Byers, PLLC.