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What do permanent rot points do. I know it sounds like a dumb question but it does not seem to be covered by the book.

There is no description in the books (AFAIK), but I always imagined it as the body breaking down due to disease, pollution, and radiation.

It doesn't do anything but ...

... every time you get a rot point you roll a number of Base Dice equal to your total amount of Rot Points and that of course includes permanent Rot Points. So if you for example are rot free and suffers one Rot Point you must immediately roll one Base Dice to see if you will get a trauma (to Strength). Every Bio Hazard (1) rolled gives you one trauma. If the same character goes out for a walkabout in the Zone and is rot free, but has one permanent Rot Point, and suffer one Rot Point during this walkabout, he must roll two Base Dice to see if he get any trauma.

You can imagine that a character with four permanent Rot Points will get crippled pretty much each time he get a Rot Point (when he suffers a Rot Point, he will have to roll five Base Dice, that is potentially up to five trauma).

Thx man

Is there a maximum of Permanent Rot and if it's the amount given on the character sheet, do you automatically die when you reach those 10 Rot Points?
or do you just keep rolling everytime you gain Rot?

There is no maximum, 10 fits the character sheet and also, if you really have that much rot, then you probably don't have that much time left.