When are permanent partial disabilities compensable under workers’ comp?

Introduction

When a person suffers an injury while on the job in Connecticut, the worker is entitled to workers' compensation benefits. There are various types of benefits, depending on the nature and extent of the injury, including: Medical treatment, temporary total disability, temporary partial disability and permanent partial disability.

This last category, permanent partial disability, is a very common type of injury, and is paid to a claimant suffering a permanent and partial loss of the use of a part of the body, due to a work-related injury. The exact amount awarded is based on the specific part of the body which was injured, a physician's determination relating to the percentage of the body part disabled, and the employee's compensation rate.

Statutory law

The Connecticut Workers' Compensation Act provides a list of body parts, together with the total weeks of compensation for each part. For example, the back is scheduled for 374 weeks. A 20 percent loss in the use of the back equals 20 percent of 374 weeks, which equals 74.8 weeks of benefits. The weekly compensation rate is determined by a complex statutory formula.

Case law

A series of recent state court cases have further defined and explained under what conditions a permanent partial disability is compensable. In 2004, in Starks v. University of Connecticut, the Connecticut Supreme Court decided that if the claimant received state disability retirement benefits she need not have her discretionary permanent partial disability benefits for a work-related back injury reduced. The court stated the retirement benefits were not part of the "weekly amount which [the claimant would] probably be able to earn" after her injury, within the meaning of the PPD statute.

In 2010, in Marandino v. Prometheus Pharmacy, a claimant had received PPD benefits for an impairment to his right upper extremity. She had also suffered a knee injury, following her arm injury, for which she then sought total disability. The Supreme Court held that a claimant is not prevented from getting total incapacity benefits for a disability if it is after, and distinct from, a condition that is not normally associated with a loss for which she has already received permanent partial disability benefits. This decision points out the distinction between these two types of benefits, permanent partial disability and total disability, and makes clear that these benefits are not mutually exclusive.

Finally, in 2011, in Sierra v. C & S Wholesale Grocers, Inc., the Connecticut Appellate Court decided that, in the absence of competent medical evidence attributing a claimant's allegations of back pain to his work-related abdominal wall injury, the workers' compensation commissioner's decision, rejecting the claim for permanent partial disability benefits for the claimant's spine based on the impairment to his abdomen, was not unreasonable, arbitrary or illegal. This decision points out the need for evidence from a medical professional, and not just the opinion or testimony of the claimant, to prove a connection between an accident at work and an alleged resulting injury.

Conclusion

If you suffer an accident at work which causes injury to one of your body parts, which you believe is permanent in nature, you should immediately contact an experienced workers' compensation attorney, who will investigate the facts of your situation and help you determine whether you have a legitimate claim for permanent partial disability benefits, based on the nature of your injury and whether you may be receiving, or may be eligible to receive, other types of retirement or disability benefits.