Loss of use of a body part. The legal term is permanent partial disability benefits. When an employee permanently loses the use or partial use of a body member, he’s entitled to permanent partial disability benefits. The neck and the back are not covered; however, many times if you have a back injury you may have problems with your legs, or if you have a neck injury, you may have problems with your arms. Then, you would get a disability rating to those body parts. As I said before, there is no money for pain and suffering but this benefit is somewhat like getting reimbursed for pain and suffering since you are being compensated for the permanent loss of range of motion. It is calculated by a standard math formula. It is the rating your doctor gives you for the loss of use of the body part member, multiplied by two-thirds of your average weekly wage, multiplied by a certain number of weeks, depending on the body part being rated.
As an example, let’s say you have a 10 percent loss of use of your right leg due to a knee injury and before the accident you made $1,000 a week. The formula would be: .10 x $666.67 x 175 weeks, which equals $11,666.73. Several things must occur before you can get permanent partial disability benefits. First, your doctor has to say that you’ve reached maximum medical improvement. This basically means that there is nothing more he can do for you and you’re not going to get significantly better than you already are as of that date. The next thing is that your workers’ compensation treating physician has to give you a disability rating to your body part that has been injured. Usually, this is done by the doctor referring you to a physical therapist to have a Functional Capacity Evaluation (FCE). Once the FCE has been completed and the physical therapist drafts a report, it is submitted to your doctor, who either approves or disapproves of the rating that the physical therapist has given. Next, the insurance company needs to agree that it is the appropriate rating and agreement forms will be created for your signature in order for you to receive your benefits. It is split up into weekly payments just as your temporary total disability benefit check. You cannot receive a temporary total (lost wages) check and a permanent partial disability check at the same time. Thus, what normally happens is that the employee is released to full duty, which stops the temporary total check, and at that point he would begin receiving his weekly checks of permanent partial disability benefits. However, if requested, the employee can ask the insurance adjuster to receive the permanent partial disability benefits in a lump sum. However, this is done at a cost. Usually, insurance adjusters request a 10 percent discount to give you your permanent partial disability benefits in one lump sum. I normally do not recommend my clients to go this route. Many times, you may receive your workers’ compensation check in a lump sum anyway, simply due to the passage of time trying to get the paperwork straight. In the above example, if paid weekly, it would only be 17 ½ weeks (4 months). I do not think it is worth $1,166.67 to get the money within the month versus spread over four months.