What if I do not accept my PPI Rating?

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It is important to note that the injured worker does not have to accept the worker’s compensation doctor’s permanent partial impairment (PPI) rating. YOUR RIGHT as an injured worker is to negotiate a higher settlement if you think the injury is serious enough that a second opinion from another specialist would likely result in a higher PPI rating.

Here are some things to consider when deciding if you should negotiate the PPI rating:

  1. Did my injury require surgery?
  2. Is my injury an aggravation of a pre-existing injury?
  3. Does the pain from the injury affect other areas of my body?

In this scenario, if you responded “yes” to the first or third question listed above, then negotiating might be a valid option for your claim. In the second question, after factoring out the old injury from the new injury, you may or may not be left with a higher rating to negotiate.

Rules of Thumb

Generally, if you are given two PPI ratings for the same injury from two different doctors, the settlement offered should be the difference (or average) of these two ratings.

On the other hand, if you are given two separate PPI ratings because you injured two different areas of your body as a result of the work accident, then the doctor will probably combine these impairments into one whole body impairment rating.

Hearings

If a dispute over a PPI settlement is not resolved between the parties involved, then the matter will be presented before a Judge. For all practical purposes, it is best if disputes over PPI ratings and settlements can be resolved without a hearing as each Judge rules differently in these matters. It is possible that the Judge will decide in favor of the lesser rating.

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