When a worker is injured and, consequently, has a permanent, not complete, impairment, he or she is typically rated under so-called Permanent Partial Disability rating (PPD rating). The rating system identifies how much money someone receives as compensation for his or her physical or mental disability, allegedly based on the degree of his or her disability. While the system is designed to ensure fair reimbursement to injured workers in the workplace, many stakeholders from doctors to lawyers and hurt workers are questioning whether the Permanent Partial Disability rating system truly lives up to its claimed objectivity and fairness.
Understanding the PPD Rating System
The PPD rating system assigns a percentage value to an employee’s permanent impairment when they reach maximum medical improvement (MMI). This is the amount of body function lost and is used by insurers and courts to calculate compensation. Ratings can be determined in a number of ways, such as by the American Medical Association’s (AMA) Guides to the Evaluation of Permanent Impairment or state schedules and guidelines.
Although it possesses a formalized process, the system is less objective than it appears, critics argue. Discrepancies in ratings provided by different doctors for the same category of injury occur more frequently than one would anticipate. The discrepancies result in enormous differences in compensation, even for individuals with similar impairments.
One of the core problems with the PPD rating system is its reliance upon clinical judgment. While medical guidelines offer assessment protocols, they also generally leave doors open to interpretation. Factors such as pain, mental health effects, and occupation-related limitations are sometimes inadequately balanced or completely ignored in overall rating.
Moreover, the physician’s labor in this role is not free of outside influences. Physicians who work for insurance companies might unconsciously, or deliberately, assign lower ratings so that there will be less money to pay out. Others assert that claimant-choice physicians might inflate ratings so that there will be more money paid out. All of these forces introduce a degree of subjectivity and bias into what is intended to be an objective medical evaluation.
Disparities Between States
A further complicating factor undermining the validity of the PPD rating system is a lack of national consistency. Each state has its own regulations, timing, and evaluation standards. As an example, compensation for a 10% disability rating of the lower back may be vastly different in two states for the same injury.
This inequality is unfair. Two employees with the same injury may receive vastly different packages of compensation depending solely on where they are employed. Employees in states whose compensation levels are lower may have additional monetary and psychologic burdens placed upon them, increasing the impact of their injuries.
The Economic Impact on Injured Workers
Permanent partial disabilities will in the majority of instances affect a worker’s capacity to work, but they are not necessarily totally incapacitated. The compensation received under current practice is not always proportional to the resulting economic impact. In the majority of cases, injured workers are coerced into accepting a lump sum or schedule amount that does not take into consideration the long-term impact on future earning capacity.
This is particularly prejudicial to employees in physically demanding jobs, where partial impairment results in losing their jobs or accepting a lower-paying job. The system, as its critics argue, lacks credibility for vocational effect as well as realized lost earnings while focusing on physical impairment in a strict sense.
Psychological Injuries
Mental and emotional trauma remain among the most poorly understood tools of disability ratings. Although psychological trauma can readily destroy one’s ability to function and return to work, rating models mostly ignore or downplay such effects. Staff members who suffer from PTSD, anxiety, or depression as a result of events in the workplace must mostly fight for recognition and fair compensation.
In essence, although the Permanent Partial Disability rating system was designed to be fair and consistent in rewarding injured workers, it is a failure in many critical areas. From unequal ratings and biased reviews to geographic discrepancies and failure to take mental health into account, the system’s failures suggest it must be overhauled. A truly fair disability evaluation model would reflect the reality of injury, not a figure on paper. Reform of the PPD rating system is no less a medical or legal necessity; it is a matter of justice for the working men and women it is designed to protect.
