Some work injuries result in a permanent loss of function to body parts affected by a workplace injury or disease.
This loss of function may continue even after complete and appropriate medical treatments. This is called a Permanent Physical Impairment (PPI). This is not the same as a disability.
Disability is an alteration of someone’s capacity to meet personal, social or occupational demands.
A PPI assessment is a medical examination to determine and measure the extent of the permanent impairment. It begins with a complete review of the claim file and is followed by a thorough physical examination of the compensable injury.
The PPI assessment determines impairment, not disability.
An impairment is objective and ratable, whereas a disability is based on numerous non-medical factors such as motivation, transferable skills, geography, job demands, etc.
Once adequate healing time and physical rehabilitation is complete, a medical review will determine if and when you qualify for this assessment. Your condition must be stable and have reached maximal medical improvement.
There is a regulated timeline that must be followed to achieve maximal medical improvement and for the physical impairment to stabilize. This can vary from six months to 24 months.
For example: A shoulder could be assessed 18 months following shoulder surgery.
WorkSafeNB must have accepted the injury as being work-related.
A permanent physical impairment rating is not provided for psychological or mental impairment when there is no physical injury. Pain and suffering are only considered when they directly affect impairment of the body’s function.
Pre-existing/personal conditions do not qualify for a PPI assessment.
A PPI assessment is conducted by a WorkSafeNB-approved medical examiner, certified by the American Board of Independent Medical Examiners (ABIME).
The physician must be independent and cannot be your current or past treating physician.
The medical examiner gathers general background information from you about your health and your compensable injury.
Then a physical exam is conducted in relation to your injury by using tests for motion, strength and sensation. These tests are not strenuous and are performed in a way to avoid discomfort.
It is important for the medical examiner to conduct as thorough a physical exam as medically appropriate for an accurate assessment. This usually takes between 20-60 minutes to complete.
You may refuse a PPI assessment, but then WorkSafeNB will be unable to determine if you are entitled to a PPI award.
Following your PPI assessment, a report will be sent to your claim manager and treating physician.
You can expect to receive a letter from your claim manager within 4-6 weeks with your assessment results.
If it is determined that a permanent physical impairment is the result of your workplace injury, an impairment rating percentage is assigned and used to calculate a PPI award.
A PPI award is a lump sum payment for a permanent physical impairment.
The award is based on your permanent physical impairment rating, measured using an approved rating schedule as outlined in Regulation 82-165, ‘Permanent Physical Impairment Rating Schedule’ of the Workers’ Compensation Act. This regulation directs WorkSafeNB to use other approved rating guides when necessary, such as the American Medical Association Guides to the evaluation of Permanent Impairment (AMA Guide). The award calculation is based on the rate of impairment multiplied by the maximum annual earnings for your accident year. The PPI award is not intended to be a claim settlement, compensation for loss of earnings, nor compensation for pain, suffering or loss of enjoyment of life. The percentage of permanent physical impairment is calculated based on the whole person rather than the injured part. An impairment is not a measure of pain and suffering; however, recommended ratings in the Schedule and Guides do make allowance for accompanying pain.
The PPI award will not affect your entitlement to other benefits under the Workers' Compensation Act, including loss of earnings and medical aid.
Travel expenses will be paid in accordance with the current approved travel policy.
If determined to be necessary, overnight accommodation expenses are paid, case by case. If you are unsure what expenses will be covered, please contact your claim manager to discuss this before booking any travel.
If you miss time from work due to this medical appointment, you will need a letter from your employer indicating the number of unpaid work hours missed and the normal rate of pay. You will subsequently be compensated for a reasonable amount of lost time.This information can be sent through a secure MyServices account or faxed to 1 888 629-4722.
For more PPI FAQs, visit worksafenb.ca. If you have further questions, contact your claim manager directly.