PPD Claim

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What is a PPD CLAIM?

In most cases, the injured worker will not be eliminated from competing in the open labor market by the permanent effects of his or her work injury, even when they are combined with any preexisting injuries or conditions. If an injured worker is able to return to work, despite the permanent effects of his or her injury being a hindrance or obstacle to employment, then the disability they have sustained while permanent is also only partial in nature. Hence, most Missouri Workers’ Compensation Claims are resolved as Permanent Partial Disability (“PPD”) cases.

How is my claim valued?

To value these cases, the State Legislature assigned a value to each body part. These State assigned values are measured in weeks of wages. For the number of weeks of wages to have a value, you must identify the PPD Rate. The PPD Rate is most commonly calculated by identifying a Claimant’s total earnings (pre-tax) in the 13-weeks prior to the date of injury and dividing that total by 13 to account for an average weekly wage (“AWW”). The PPD Rate is then two-thirds of that AWW. The PPD Rate is always subject to a cap. That cap increases each year after June 30th. If you PPD Rate is less than that year’s statutory maximum, then your PPD Rate and TTD Rate should be the same. If the PPD Rate maximum applies to you, your TTD rate is likely higher (maybe substantially so) than your PPD Rate. Either way, your PPD Rate and the number of weeks the body part you injured is worth according the the State Legislature should be pretty straight forward.

How can an attorney add value to my PPD claim?

If an attorney is going to add value to your PPD Recovery, very often, the attorney will do so by obtaining evidence, or otherwise advocating, for a higher PPD Rating. This rating is most often provided to you by the Workers’ Compensation Employer/Insurer and their doctor(s). It will appear in your case in the form of a percentage. In a nutshell, that percentage is supposed to reflect how much less ‘able’ the body part you injured will be on a permanent basis moving forward. As such, it is common that Employers/Insurers’ physicians will assign what seem like very low PPD Ratings. These low ratings directly correlate to low case values (small recoveries / settlements). This is where the second opinion can have additional value. If that IME results in a conclusion that the injured worker has achieved MMI, in addition to the future medical considerations, the second opinion physician will provide a PPD rating of his or her own that can be submitted into evidence. This is the last piece of the puzzle in the PPD equation. At that point, you know the number of weeks the body part you injured is assigned by the State, you know your PPD Rate (or, if it is capped at the max), and you know the PPD Rating the workers’ compensation treating physician assigned you compared to the PPD Rating your second opinion IME doctor assigned you.

Simply apply the PPD Rating (percentage) to the Total Number of Weeks Your Injured Body Part(s) are Assigned, and then multiply that by the PPD Weekly Rate.

Back Injury Examples: L4-5 Fusion Surgery if PPD Rate was $500

40% PPD Rating at the Low Back (400 Week Level)

40% of 400 = 160 Weeks

160 Weeks with $500 PPD Rate = $80,000.00

5% PPD Rating at the Low Back (400 Week Level)

5% of 400 = 20 Weeks

20 Weeks with $500 PPD Rate = $10,000.00