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Attending a PPD Rating Exam when More Treatment Is Needed

Injured workers should attend their scheduled permanent partial disability exam whether or not additional treatment may be needed. Failing to attend a PPD exam when additional medical treatment is necessary may result in a denied claim and loss of benefits.

The Importance of PPD Rating Exams

Nevada workers’ compensation insurance covers employees for all job-related injuries and occupational illnesses and/or diseases. When workplace accidents and injuries occur, many workers are eligible for permanent partial disability (PPD) benefits which begin after a worker has reached “maximum medical improvement.” PPD awards are commonly granted for serious injuries that cause permanent impairment, disability, or disfigurement.

PPD payments are paid to injured workers who sustain permanent injuries or impairments, but are still able to perform work in some capacity. To receive PPD benefits, a worker must be examined by a licensed medical professional who establishes the level of injury or impairment. A physician who handles workers compensation cases will assess the worker’s physical and mental condition through a physical exam and a variety of tests. Based on the PPD rating exam and tests results, the physician will use state-required guidelines to determine the degree of permanent disability.

PPD benefits begin near the end of a workers compensation claim, after a worker has reached maximum medical improvement and has been evaluated by a licensed physician for permanent disability. If PPD benefits are denied or the case is closed, a worker can file an appeal. The insurer will likely schedule an additional PPD rating exam to determine the degree of permanent disability. If the worker fails to attend this exam, he/she may lose PPD benefits completely.

States use PPD rating exams to determine the amount of monetary compensation a worker will receive for permanent injuries or impairments caused by work-related injuries and/or occupational diseases. Whether it’s a new claim or reopen a claim, a worker must comply with all PPD exam requirements to receive benefits. In Nevada, PPD ratings must be established by a licensed physician or chiropractor on a list that’s controlled by the Nevada Division of Industrial Relations (DIR). The exam must indicate that a worker is in “stable and ratable” condition, meaning that he/she has reached maximum medical improvement, and that his/her injury or disease is medically stable. If a worker disagrees with a PPD evaluation, he/she may request a second evaluation from another physician on the DIR’s rotating physician list.

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