October 31, 2008, Newsletter Issue #32: How Permanent Partial Disability Benefits Work

Tip of the Week

It is ironic that the one constant surrounding permanent partial disability benefits, and determinations is that there is little consistency of definition. For instance, were you to examine the otherwise similar looking workers compensation coverages for a number of different states, you’d likely find a wide variety of definitions, benefit limits, and terms of protection. If you then compared these with coverage offered by municipalities and private disability insurance companies, you’d have a longer list of inconsistencies.

“What is permanent partial disability?” is a question that can be defined differently because of the many “gray” areas of physical conditions. For example, assume you are an ophthalmologist with a practice divided roughly equally into diagnostic medicine and surgery. You suffer an injury to one or both hands that allows you to continue as an outstanding diagnostician, but you are now unable to perform surgery. If medical experts believe that this condition should continue permanently, you may be declared to have a permanent partial disability rating.

Your disability insurance contract may offer benefits to you based on around 50% of your normal total monthly income being lost. The percentage of lost income your insurance coverage will provide and the length of time you can receive these benefits will be stipulated in your contract. Should you have selected that benefits continue up to the age of 65, this disability income should continue to that date.

This is a simple example but these situations can sometimes become convoluted and much more complex. Because there appears to be a lack of consistency in the language defining permanent partial disability, read your insurance contract carefully to learn how you are covered. Should your terms be insufficient for your needs, you may have the opportunity to enhance this coverage through the addition of a rider to your policy.

Refer to your insurance policy contract for specific information regarding your coverage and for actual terms, conditions and exclusions. The above statements are general in nature and may or may not reflect the actual terms of your insurance policy.

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