PPD Evaluations: Should You Have One?

By Jason Weinstock on February 16, 2011

There were 5,528 permanent partial disability ratings done in Nevada in fiscal year 2010, according to a recent email to me from the Medical Unit of the Workers’ Compensation Section (WCS) of DIR.  The Research and Analysis people at the WCS are not done compiling the data on the total number of claims filed for fiscal year 2010, but they told me that in fiscal year 2009, a total of 58,516 claims were filed.  Assuming the total number of claims filed for fiscal year 2010 is the same, then only about 10% of claimants had an  impairment evaluation.  That percentage may be higher if the number of claims filed in fiscal year 2010 is actually lower than the prior year.

The overwhelming majority of claims filed in Nevada are medical only claims.  Most  injured worker get  medical treatment, never miss any time from work, and don’t  have a permanent impairment as a result of their work accident or illness.  If all of the injured workers in Nevada who actually had permanent impairments were rated, then it is fortunate that only 10% of all workers who filed claims had injuries that warranted an impairment evaluation.  Unfortunately, there  is no way to know how many workers should have had a rating evaluation before their claims were closed, but did not.  

An insurer only schedules a rating if the treating physician states on the final physician progress report that it is likely that the injured worker has a ratable impairment.  The problem is that many treating physicians are not familiar with the book used to determine a ratable impairment.  For example, there are still some orthopedic surgeons in southern Nevada that do not know that a partial meniscal repair of the knee is an automatic 1% whole person impairment under the AMA Guide to Evaluation of Permanent Impairment, 5th edition (the book the rating physician must use under current Nevada law). Other physicians do not realize that an injured worker may be entitled to an impairment award  under the AMA Guides even though he is released full duty to his job. 

Do you think that you have a permanent work injury and that you should have had a rating evaluation for a PPD award?  If so, then obtain a copy of your medical records immediately.  In general, if you are still having serious, permanent  problems with your injury, you may have a ratable impairment  It’s free to have me review your records.  Keep in mind that It is much more difficult to reopen a claim that was closed a long time ago just to get a rating evaluation. Legally, it is easier to get an evaluation when the insurer closes your claim  The sooner you get legal help, the better your chances are for correcting any mistakes and getting what is rightfully yours.