The right response depends on what you received. A proposed PPI agreement is different from a Board-approved agreement or award, and a Section 15 full-and-final settlement is different again.
Key takeaways
- Read the complete medical report and proposed agreement before signing.
- Indiana Code 22-3-3-10.5[1] requires specified documents to accompany a proposed PPI agreement, including the physician’s statement and an employee waiver of examination.
- State Form 53913 says the employee may obtain an examination by a qualified physician of the employee’s choice at the employee’s own expense; the resulting rating may be considered but is not binding on the employer or carrier.
- The Board offers informal assistance, but an unresolved dispute requires the formal claim process for adjudication.
- Match any timing guidance to the claim’s dates, payments, filings, documents, and requested relief.
What a PPI rating means
Indiana Code 22-3-3-10[2] contains the statutory schedule for permanent partial impairment compensation. The Worker’s Compensation Board also publishes a PPI evaluation-and-processing guide[3] and PPI calculation materials[4].
The Board’s October 2023 guide addresses evaluation and processing of PPI ratings.
A zero-percent figure records the evaluator’s conclusion for that report; other disputed questions may remain.
For sample arithmetic, try the firm’s PPI calculator. It does not produce an evaluation or a Board order.
How to review a zero or low rating
Start with the complete report, not only the percentage. Compare the report with the body part identified in the claim and the medical records available to the evaluator.
- Which injury and body part does the report evaluate?
- Does it state that maximum medical improvement has been reached?
- Which examination findings does it record?
- Does the proposed agreement match the physician’s percentage and body part?
- Are you also being asked to sign State Form 53913, the personal-physician examination waiver?
Ways to dispute a proposed PPI rating
Ask for the complete proposal
Indiana Code 22-3-3-10.5[1] says a proposed PPI agreement, the associated physician’s statement, an employee waiver of examination, and a hand/foot chart if necessary must be tendered to the employee no later than 15 days after the physician’s statement. Review the documents together before deciding whether to sign.
Consider a personal-physician examination
The Board’s official forms page[5] lists State Form 53913, “Employee Waiver of Examination by Personal Physician.” The form says the employee has a right to an examination by a qualified physician of the employee’s choice, at the employee’s own expense, to determine the degree of PPI. It also says a rating obtained from that examination is not binding on the employer or carrier, although it may be considered.
That form-based option should not be confused with the Board’s independent-medical-examination procedure for an objection to a proposed termination of temporary disability benefits. A low PPI rating alone does not establish entitlement to a Board-funded examination under that separate procedure.
Request informal Board assistance
The Board’s informal-disputes page[6] says the process begins by filing a completed Request for Assistance, State Form 45442. A Case Coordinator may investigate and try to help resolve the matter. This is an administrative resolution process, not a decision by a hearing member.
Use the formal claim process for adjudication
The Board’s disputed-claims page[7] says an unresolved dispute moves forward only if an Application for Adjustment of Claim, State Form 29109, is filed. The Board assigns the case to a Single Hearing Member, the parties present evidence, and the hearing member issues an award. The same page explains that review by the Full Board requires an Application for Review, State Form 1042, initiated within 30 days of the hearing member’s award.
Records to organize
| Record | What to check |
|---|---|
| Complete physician’s report | Body part, percentage, MMI statement, findings and signature |
| Proposed PPI agreement | Whether its rating and body part match the report |
| State Form 53913 | What the signer is being asked to give up for this agreement |
| Treatment records | What information was available when the rating was prepared |
| Board filings and orders | What has been filed, approved, or adjudicated |
| Payment records | The dates and periods for which compensation was paid |
Related background appears in the firm’s MMI guide.
Timing and claim documents
The Board’s disputed-claims page states that an Application for Adjustment of Claim must be filed within two years of the date of injury. That general statement does not answer every PPI timing question after compensation has been paid or an agreement or award already exists.
Indiana Code 22-3-3-27[8] gives the Board continuing jurisdiction to modify an award for a change in conditions, subject to statutory limits. It generally requires an application within two years from the last day for which compensation was paid, but provides a one-year period when the modification sought would increase PPI. The statutory reference point is the last day for which compensation was paid, not necessarily the date a check arrived.
The Board’s employee page says an Agreement to Compensation or compromise agreement may be reopened for a change of condition within the Section 27 periods. The same page says a Section 15 full-and-final settlement cannot be reopened unless fraud in the settlement process can be proved.
These provisions address different procedural settings. Informal communications are not a substitute for determining whether a Board filing is required in a particular claim.
Before signing a PPI agreement or settlement
Indiana Code 22-3-3-10.5[1] says a PPI agreement signed by the employee, with the required supporting documents, must be submitted to the Board for approval no later than 15 days after receipt from the employee. It also requires the first installment or an agreed lump sum to be paid no later than 30 days after Board approval.
Before signing, classify the paperwork: a proposed PPI agreement, State Form 53913, or a broader settlement. Confirm the body part and percentage, keep a copy, and compare any reopening language across the actual documents.
For related context, read what to know before signing an Indiana workers’ compensation settlement or visit the firm’s workers’ compensation practice page.
Frequently Asked Questions
Must I accept a proposed zero PPI rating?
No. You can leave the proposed agreement or State Form 53913 unsigned. Other sections above describe the employee-selected examination and the Board’s informal and formal paths. Which step is useful depends on the claim’s posture.
Is another physician’s PPI rating binding?
No. State Form 53913 says a rating from the employee’s chosen physician is not binding on the employer or insurance carrier, although it may be considered.
Does a low PPI rating automatically provide a Board-funded IME?
No. The Board describes an IME procedure in connection with certain objections to termination of temporary disability benefits. That is not an automatic PPI-rating appeal procedure.
Which form starts formal adjudication?
The Application for Adjustment of Claim, State Form 29109, starts the formal claim process described by the Board. State Form 45442 requests informal assistance instead.
How long do I have to dispute a rating?
The answer depends on whether the matter involves an initial claim, a proposed agreement, an existing award, a change of condition, or a full-and-final settlement. The Board states a general two-year injury-date deadline for an Application for Adjustment of Claim. Indiana Code 22-3-3-27[8] supplies different periods for specified changes after compensation or an award.
If you received a zero or low PPI proposal, Delventhal Law Office can review the report and paperwork and discuss whether the firm can assist. You may use the free consultation form.
This article is general educational material, not legal advice for a particular matter. It does not recommend accepting or rejecting any individual agreement or settlement. Contacting Delventhal Law Office is only a request to discuss possible representation, which the firm may or may not offer. Any assessment depends on the governing rules, documents, evidence, and specific facts.
Sources
- Indiana Code 22-3-3-10.5 (iga.in.gov) ↩
- Indiana Code 22-3-3-10 (iga.in.gov) ↩
- PPI evaluation-and-processing guide (secure.in.gov) ↩
- PPI calculation materials (secure.in.gov) ↩
- official forms page (secure.in.gov) ↩
- informal-disputes page (in.gov) ↩
- disputed-claims page (in.gov) ↩
- Indiana Code 22-3-3-27 (iga.in.gov) ↩
