Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living. If your injury or illness results in PD you are entitled to PD benefits, even if you are able to go back to work.
Do I need to fill out the claim form?
Yes, if you want to make sure you qualify for all benefits. If you do not file the claim form within a year you may not be able to get benefits. Your employer must give you a claim form within one day of knowing you were injured. Filling out the claim form opens your workers’ comp case. State law also lays out benefits beyond the basics you may qualify for once you file the claim form with your employer. Those benefits include, but are not limited to:
• A presumption that your injury or illness was caused by work if your claim is not accepted or denied within 90 days of giving a claim form to your employer
• Up to $10,000 in treatment under medical treatment guidelines while the workers’ compensation insurance considers
• An increase in your disability payments if they’re late
• A way to resolve any disagreements that might come up between you and the insurance over whether your injury or illness happened on the job, the medical treatment you receive and whether you will receive PD benefits.
What if my employer didn’t give me the DWC 1 claim form?
Ask your employer for the form or call our attorneys.
Who decides if I should get PD benefits? How is that done?
A doctor decides if your injury or illness caused PD. The doctor’s report is then turned into a PD rating. The process used to turn the doctor’s report into a rating can vary depending on your date of injury and other factors. The PD rating determines the benefits you’ll receive. After your doctor decides your injury or illness has stabilized and no change is likely, PD is evaluated. At that time, your condition has become permanent and stationary (P&S). Your doctor might use the term maximal medical improvement (MMI) instead of P&S. Once you are P&S or have reached MMI, your doctor will send a report to workers’ compensation insurance career telling them whether you have any PD. The doctor also decides if any of your disability was caused by something other than your work injury, such as a previous injury or another condition. This is called apportionment.
What if I don’t agree with the doctor?
If you or the workers’ compensation insurance career disagrees with your doctor’s findings you can be seen by a doctor called a qualified medical evaluator (QME). QME process is complicated and there are specific and strict timelines you must meet in filing your QME forms or you will lose important rights. We suggest you seek representation by an attorney during QME process.
What is a PD rating and how is it calculated?
First, after your exam, the doctor will write a medical report about your impairment. Impairment means how your injury affects your ability to do normal life activities. The report includes whether any portion of your impairment was caused by something other than your work injury. The doctor’s report ends with an impairment number. Next, the impairment number is put into a formula to calculate your percentage of disability. Disability means how the impairment affects your ability to work.
How is PD paid?
Once your doctor says you have PD, the workers compensation insurance career will estimate how much you should receive and begin making payments to you, even if the final percentage of disability has not been calculated. PD benefits are paid in addition to temporary disability (TD) benefits you received.
How is my claim finally resolved?
After the amount of PD in a claim is determined, there is usually a settlement or award for benefits. This award must be approved by a workers’ compensation judge. If your doctor said further medical treatment for your injury or illness might be necessary, the award may provide future medical care. There are two types of settlements. A settlement is agreed on by you and the workers’ compensation insurance career. You can resolve your whole claim through one lump sum settlement called a compromise and release (C&R).
What is C&R
A C&R may be best when you want to control your own medical care and/or you want a lump sum payment for your PD. A C&R usually means that after you get the lump sum payment approved by the workers’ compensation judge, the claims administrator will not be liable for any further payments or medical care.
What is Stipulation?
You can also agree to a settlement called a stipulation with request for award (stip). A stip usually includes a sum of money and future medical treatment. Payments take place over time. A judge will review the agreement.
What is Finding and Award
If you cannot agree to a settlement with the claims administrator, you can go before a workers compensation judge, who will decide your PD award. A judge’s finding is called a findings and award (F&A). The F&A generally consists of an amount of money and a provision for the workers’ compensation insurance career to pay for approved future medical treatment.
Protect your rights and contact us
Consult Statewide Law attorney: We help injured workers with their workers’ compensation claims . Our job is to plan a strategy for your case, gather information to support your claim, keep track of deadlines and represent you in hearings before a workers’ compensation judge at your local Workers’ Compensation Appeals Board office. If you hire one of our attorneys, the attorney’s fees will be taken out of benefits you receive. A judge must approve the fees.
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