Q & A: Permanent partial disability, Subrogation impact on Experience Mod, vacation pay, and ownership requirements for combining Workers' Compensation policies
Q. “Can someone with no work restrictions still have a permanent partial disability?”
A.Yes, a Permanent Partial Disability (PPD) is when a worker has been assigned a Maximum Medical Improvement (MMI) and is capable of returning to gainful employment, but with some loss of function or residual problems as a result of the injury. The injured employee's condition has stabilized to the point that no significant change in medical condition is expected, in spite of continuing medical treatment. Someone can reach MMI with an impairment rating and still be fit enough to do their job without restrictions. In essence, the person is not at the same physical level as before the injury; however, the impairment does not rise to the level to restrict the essentials functions of their job.
Q. “We are working through a large WC subrogation claim and as we wait for the carrier to subrogate, we are being hit with the negative effect on our E-mod. Once they do subrogate, can we go back, revise the E-mod retroactively and have a return of premium?”
A. Yes, it is possible to go back and revise Mods and get any return of premium due. However, some words of caution. Subrogation will not likely return 100% of the dollars spent. It is possible that even after subrogation, the amount left over may be quite high, and perhaps above your State Maximum. There are instances when subrogation has no effect on the Mod.
Q. “If an employee opted for the wages instead of vacation, is that considered Excluded Remuneration?”
A. No, vacation pay, whether the vacation is taken or not, is Included Remuneration.
Q. “What is the rule of combining Worker's Comp policies if an owner is 100% owner of one company and 50% owner of another?”
A. The two companies can not be combined because they must share MORE than 50 percent common ownership.