Benefits Application

Permanent Partial Disability Calculator

This calculator is meant to provide calculation assistance to determine the amount due for scheduled and whole person permanent impairments (PPD).

Whole Person Impairment Calculator:

Name

*Claimant’s DOB:

*Claimant’s DOI:

*Claimant’s Date of MMI:

*Percentage of impairment:

*TTD rate:

Age:

Total whole person PPD award:

PPD payment rate:

Weeks to Payout:

Scheduled Impairment Calculator:

Name:

*Claimant’s DOI:

*Percentage of impairment:

*Body code:

Loss:

Weeks:

Total schedule PPD award:

PPD payment rate:

Reminder:

A claimant’s status as a minor, less than 21 years old at the time of injury, does not change although the claimant may be older at the time of MMI. When calculating whole person impairments for minor claimants, use the max TTD rate at the time of MMI.

Code	Loss	Weeks