Fourth Quarter 2017
By: Stephen McGrady
Question: Under Indiana law, can an impairment rating be submitted into evidence and how effective are the ratings in mitigating permanency exposure?
Short Answer: Yes. An impairment rating may be submitted into evidence in Indiana; however, its effectiveness in mitigating permanency exposure in Indiana is limited.
Discussion: The effect of an impairment rating in Indiana is a different beast from many other jurisdictions as the physician’s impairment rating is essentially one and the same as the permanency exposure. For Indiana worker’s compensation claims, once the injured worker is determined to have reached maximum medical improvement, the employer has a duty to obtain a Permanent Partial Impairment (PPI) rating and to offer compensation for the employee’s permanent impairment according to that rating.
The monetary values of PPI awards are set by statute. For example, if the authorized physician issues a 10% whole person impairment rating for injuries resulting from an accident in June 2017, the claimant would be entitled to PPI compensation of $17,500 (10 degrees times $1,750 per degree). PPI exposure calculation depends on the following: 1) degree of impairment, 2) the date of the accident, and 3) the body parts involved. If a single accident results in impairment to multiple body parts, the impairment ratings for each body part can be combined appropriately.
In general, the Indiana Worker’s Compensation Board members will give credence to a PPI rating issued by a qualified physician. The difficulty becomes how to reconcile two or more differing PPI ratings. Attorneys for the injured workers have increasingly been sending injured workers to their own doctors in an effort to obtain alternate PPI ratings, and increase permanency compensation as a result. Reasonable doctors can reasonably interpret signs of permanency in different ways (particularly if they are using different editions of the Guides for Permanency – ratings from the 5th edition typically result in a higher rating than those from the 6th edition, and there is no volume mandated for use in Indiana). If two differing ratings are brought before the Board at a permanency hearing, the Board’s tendency has not been to decide which doctor they believe to be more credible, but to “split the baby” down the middle.
Practice Tip: The use of PPI ratings in Indiana is statutory, and simply requires a straightforward calculation in most cases to determine the appropriate permanency award. If disputed by an alternative rating obtained at the Claimant’s expense, the best practice is to try to negotiate an impairment award somewhere between the two PPI ratings unless there is specific evidence available to discredit the employee’s PPI rating,.