Defending an Individual’s Claim of Permanent Total Disability.
Every employer wants to avoid permanent total disability claims. From the moment an injury occurs, an employer is susceptible to an injured worker filing for PTD benefits.
Properly defending a PTD claim can mean the difference between successful claim resolution and a lifetime of benefits at a high dollar amount.
What is a Permanent Total Disability Assessment?
VocWorks’ PTD Assessment product can assist employers in successfully defending PTD claims by illustrating an individual is capable of remunerative employment.
Our highly qualified vocational specialists, whom all hold Certified Rehabilitation Counselor (CRC) certifications, perform a comprehensive evaluation of a claim file and examine the local labor market to determine if an individual is employable.
As part of the process in determining an individual’s ability to sustain remunerative employment, the vocational specialist examines and analyzes a variety of information, which may include:
- medical documentation;
- individual’s age and education;
- work and vocational history;
- labor market conditions; and,
- unemployment rates.
Following the assessment, the vocational specialist provides a comprehensive report which documents their assessment findings and professional opinion of the injured worker’s capability of remunerative employment.
Suggested Documentation for PTD Defense
- Any recent medical information, usually no older than one year, including documented physical capacities, physician notes, operative reports and diagnostic information.
- Any and all IME reports and FCE reports related to the case. In many cases, a series of IMEs and FCEs over a period of years can show progression in a case and assist the vocational specialist in documenting an injured worker’s ability to sustain remunerative employment.
- Any vocational information, including work history and vocational evaluation reports.
- If a psychological allowance is part of the claim, a physician or therapist’s statement that the injured worker can work and an indication of the injured worker’s mental capacity. This statement, usually in the form of a narrative or checklist, should describe the injured worker’s ability to manage daily functions, such as balancing a checkbook and managing moderate stress.
- Any documentation or indication that the injured worker voluntarily removed themselves from the labor market.
Factors Influencing the Effectiveness of PTD Assessments
Keep in mind that a variety of factors exist which may influence the effectiveness of a PTD assessment. An employer may want to re-evaluate, with their legal counsel, if a PTD assessment should be completed if:
- The employer’s IME physician opines that the individual is permanently and totally disabled.
- If there is any uncertainty or controversy in the Maximum Medical Improvement (MMI) status.
- If any further treatment is being recommended or pursued by the claimant’s physician of record.
- If a medical condition or combination of medical conditions may warrant that the PTD award is automatic statutory (i.e., amputation).
Vocational Evaluation and Permanent Total Disability Assessment: What’s the Difference?
Vocational evaluations and PTD assessments are two very different types of assessments, each used at a distinct point in the life of a claim.
Not sure which assessment to use? Examine the case for the information below to help you determine the most appropriate assessment to support resolution of the claim. A VocWorks Account Manager can assist you in the process of determining the correct evaluation.
A PTD assessment is used to determine a person’s employability and ability to sustain remunerative employment.
This type of assessment is necessary to defend against a claim of permanent total disability and is used when a claimant submits a formal application for PTD compensation. Many times, there are several claims involved, some of which can be several years old.
A vocational evaluation, on the other hand, is used much earlier in a claim, when an injured worker is not able to return to their original job, but is appropriate for alternative work in a different job with a different employer.
In situations where the original employer is not able to offer a job to the injured worker, a vocational evaluation is appropriate shortly following documentation of permanent restrictions and maximum medical improvement.
The purpose of a vocational evaluation is to identify transferable skills and appropriate job goals for the injured worker to use in an individualized job search.