The PPD rules tell the doctors how to measure your impairment and they tell the claims managers how much, if any money L&I will want to pay you.
These PPD rules are complex. They were written by politicians and insurance people and intended to be understood by doctors, lawyers, and judges.
The PPD rules are part of the law governing L&I claims. You can find these rules by looking at the statutes in the Revised Code of Washington (RCW ) Title 51, and you can find the administrative details in the Washington Administrative Code (WAC) Title 296. See our Things You Need to Know page for links to these laws. First, understand how they work.
The category rating system is a volume of complex medical-legal rules and category award charts. The rules are fairly static but the charts change every year based on your date of injury.
The category rating section for body systems includes: cervical, dorsal, dorsolumbar and lumbosacral spine, pelvis, neurological system, mental health, respiratory, taste and smell, speech, skin, and internal organs.
Category 1 usually pays zero, Category 2 pays some money, and Category 3 pays more. The charts for your date of injury year will show you how much money your category rating is worth.
The specified disability section has complex medical-legal rules and a PPD Award Schedule which changes each year based on your date of injury.
The specified disabilities section includes: legs, feet, arms, heads, eyes, and hearing.
The important details are contained in the Washington Annotative Code (WAC). Each specific body system or specified disability in the WAC is roughly divided into two, with rules for evaluation of that category followed by the specified body system and the corresponding objective clinical findings. There are also general rules for impairment rating RCW 51.32.080 and WAC 296-20-2010. There are special rules for evaluation of permanent bodily impairment WAC 296-20-220. There are Permanent Partial Disability Awards Schedules which change every year. These award schedules convert percentages or categories into dollars, and allow for modest yearly increases to reflect the percentage change in the consumer price index.
The WAC’s provide complex medical/legal determinations meant to attach a percentage to an impairment of loss of function. That percentage is taken to the PPD schedule for the year of your injury, to determine the dollars you should be awarded at claim closure. The money is often paid out over the course of several months.
Impairment Ratings are performed by doctors in anticipation of claim closure. The rating is the doctor apply the PPD rules to your L&I accepted medical conditions. They are usually found in an IME report or your physicians final report.
Be careful of IME’s. These often produce unfriendly and unfair impairment ratings. Learn about IME’s at Independent Medical Examinations.
The award charts is where the impairment rating is converted into dollars. These charts change every year on July 1. Look at the date of your injury to pick the correct year.
Each year starts on July 1
If these rules are too complex, not to worry. You don’t have to know how to apply the rules to get paid. We can tell you what L&I plans to pay you, if you can tell us: