04-28-2009, 07:47 PM
Here is what happened with my IR that I had on the 16th. The doctor that did it put me at permanent partial 8% as a whole body for my right arm and wrist, and at clinical MMI. Stated that I would need periodic treatment for the injury, but that everything that could be done for the injury itself has been done. (treatment, therapy, meds, etc) which is funny since I haven't had one of any of these since my claim was started, other than a shot of toradol in the ER. I guess it must be one heck of a med if it can cure all that they found wrong with me since I had that shot.
I am curious though, to see how the 8% IR is going to play out with the 8% body as a whole that I received in 2004 with my first wc injury (wrist and hand). This new IR includes the wrist, but not the hand. So I figure there will have to be some kind of aggregate disability on the wrist, as it is the only part that is common between the 2, and then somehow it will all have to be combined to come up with one total. I guess either my attorney, or my Dr will be able to tell me
He used Guides to the Evaluation of Permanent Impairment, fourth edition, 1st,2nd,3rd or 4th printing, including corrections and changes issued by the AMA prior to May 16, 2000. Isn't there a more recent issue ?? With the way medicine changes every day, you would think there would be.
Hope that you bear with me on this one. Here is a synopsis of some of what he wrote:
treatment history from records received:
3/12/2008 treatment notes from URHE
5/15/2008 Dr. Babalola Oluwole examined worker, determined findings consistent with upper right extremity repetitive trauma injury related to job.
5/19/2008 Dr Jim Mitchell, my current treating Dr of record, examined worker. Determined examinee's signs and symptoms directly related to work injury.
5/19/08 Dr Jim Mitchell evaluated right shoulder elbow and wrist x-rays. No significant clinical abnormalities but did report an artifact at distal radius.
5/28/08 Physical Performance examination performed.
01/08/09 right elbow MRI
1. normal alignment of the radiocapitellar and humeroulnar joint associated with minimal joint effusion
2. subtle bone bruise of radial head and the coronoid process of the ulna
3. probable cell artifact to account for increased signal in the olecranon since not verified on the STIR image
4. tendinosis/tendinopathy and post traumatic inflammatory and reparative change involving the insertion of the common flexor tendons of the medial epicondyle
5. normal radial and ulnar collateral ligaments, common extensor tendon, intact biceps and triceps tendon
6. normal cubital tunnel
01/08/09 right shoulder MRI
1. normal glenohumeral alignment without evidence for labroligamentous disruption
2. subtle bone bruise of the distal clavicle associated with subacute arthritic changes of the AC joint and subacromial bursitis
3. there is intact rotator cuff
(of course the MRI's were taken almost a year since I first started having my troubles)
01/14/09 Upper extremity electrodiagnostic study was performed. Sensory abnormality of the radial nerve on the right, abnormality in the Ulnar nerve in left and bilateral Median nerve abnormality
04/02/09 Dr Mitchell re-evaluated IW and determined that she was not able to return to work.
( I have seen Dr Mitchell on a monthly basis since August, so that he could determine if I was able to return to work).
These are the IR Dr's findings:
Palpatation of R shoulder revealed tenderness on all surfaces, as well as the AC joint, SC joint and biceps tendon
Palapatation of R elbow revealed tenderness of the lateral epicondyle
palpitation of R wrist revealed reported tenderness on the dorsal and radial surfaces
active motion in R shoulder revealed mild to moderate joint crepitation
Active motion on R elbow and wrist revealed no crepitiation
Biceps, triceps and brachioradialis deep tendon reflexes were +2 on Wexler scale bilaterally.
Upper extremity motor evaluation revealed mild weakness (4/5) in grip strength on right. All other motor was within normal limits.
Upper extremity dermatomes evaluated bilaterally using a disposable pinwheel. C5 dermatome reported to have diminished sensation on right.l C6, C8 and T1 dermatomes were reported to have stronger sensation on right than left. C7 was reported equal bilaterally.
Upper extremity vibratory sensation was within normal limits bilaterally.
Hoffman's reflex absent bilaterally
Yergason's test on R shoulder positive for tenderness but negative for instability
Codman's was - on R
Dawbarn's - on R
Mill's + at r elbow
Cozen's + at R elbow
Tinel's tap - in R elbow and wrist
Finklestein's test + on wrist (he actually performed Eichhoff's test not finklestien's)
Phalen's - on R wrist
Circumference of upper exteremity musculature was measured bilaterally Above elbow 31 1/2cm, below elbow 27 cm both bilaterally.
Summary:
the total upper body impairment was 14%. Table 3 (page 20) converts this to 8% body as a whole person. This becomes the final whole person impairment rating. It should be noted that this injured worker would benefit from Periodic care in the future in order to maintain the biomechanical improvement she has achieved under her treating doctor's treatment plan.
I will be seeing my treating Dr on Thursday, and following up with a face to face for the first time since I hired her over a year ago, with my attorney. I think, if it is all played out right, I should have my claim accepted no later than the end of May. Especially since we found fraud committed on the original Employers' first report of injury. And it just wasn't one little error, but three. The adjustor has already filed a new report of injury (this one has the actual reported date of first injury on it) and by the end of the month, instead of having a mess of three claim numbers for the same injury, it will all be under just one that the court will accept. Heck, I may find that come Thursday afternoon when I meet with my attorney that I have an accepted claim and be getting a check soon ~LOL~ as if WC moves that fast !!!
Will let you know what happens at the Dr's and attorneys on Friday.
Angel ^j^
I am curious though, to see how the 8% IR is going to play out with the 8% body as a whole that I received in 2004 with my first wc injury (wrist and hand). This new IR includes the wrist, but not the hand. So I figure there will have to be some kind of aggregate disability on the wrist, as it is the only part that is common between the 2, and then somehow it will all have to be combined to come up with one total. I guess either my attorney, or my Dr will be able to tell me
He used Guides to the Evaluation of Permanent Impairment, fourth edition, 1st,2nd,3rd or 4th printing, including corrections and changes issued by the AMA prior to May 16, 2000. Isn't there a more recent issue ?? With the way medicine changes every day, you would think there would be.
Hope that you bear with me on this one. Here is a synopsis of some of what he wrote:
treatment history from records received:
3/12/2008 treatment notes from URHE
5/15/2008 Dr. Babalola Oluwole examined worker, determined findings consistent with upper right extremity repetitive trauma injury related to job.
5/19/2008 Dr Jim Mitchell, my current treating Dr of record, examined worker. Determined examinee's signs and symptoms directly related to work injury.
5/19/08 Dr Jim Mitchell evaluated right shoulder elbow and wrist x-rays. No significant clinical abnormalities but did report an artifact at distal radius.
5/28/08 Physical Performance examination performed.
01/08/09 right elbow MRI
1. normal alignment of the radiocapitellar and humeroulnar joint associated with minimal joint effusion
2. subtle bone bruise of radial head and the coronoid process of the ulna
3. probable cell artifact to account for increased signal in the olecranon since not verified on the STIR image
4. tendinosis/tendinopathy and post traumatic inflammatory and reparative change involving the insertion of the common flexor tendons of the medial epicondyle
5. normal radial and ulnar collateral ligaments, common extensor tendon, intact biceps and triceps tendon
6. normal cubital tunnel
01/08/09 right shoulder MRI
1. normal glenohumeral alignment without evidence for labroligamentous disruption
2. subtle bone bruise of the distal clavicle associated with subacute arthritic changes of the AC joint and subacromial bursitis
3. there is intact rotator cuff
(of course the MRI's were taken almost a year since I first started having my troubles)
01/14/09 Upper extremity electrodiagnostic study was performed. Sensory abnormality of the radial nerve on the right, abnormality in the Ulnar nerve in left and bilateral Median nerve abnormality
04/02/09 Dr Mitchell re-evaluated IW and determined that she was not able to return to work.
( I have seen Dr Mitchell on a monthly basis since August, so that he could determine if I was able to return to work).
These are the IR Dr's findings:
Palpatation of R shoulder revealed tenderness on all surfaces, as well as the AC joint, SC joint and biceps tendon
Palapatation of R elbow revealed tenderness of the lateral epicondyle
palpitation of R wrist revealed reported tenderness on the dorsal and radial surfaces
active motion in R shoulder revealed mild to moderate joint crepitation
Active motion on R elbow and wrist revealed no crepitiation
Biceps, triceps and brachioradialis deep tendon reflexes were +2 on Wexler scale bilaterally.
Upper extremity motor evaluation revealed mild weakness (4/5) in grip strength on right. All other motor was within normal limits.
Upper extremity dermatomes evaluated bilaterally using a disposable pinwheel. C5 dermatome reported to have diminished sensation on right.l C6, C8 and T1 dermatomes were reported to have stronger sensation on right than left. C7 was reported equal bilaterally.
Upper extremity vibratory sensation was within normal limits bilaterally.
Hoffman's reflex absent bilaterally
Yergason's test on R shoulder positive for tenderness but negative for instability
Codman's was - on R
Dawbarn's - on R
Mill's + at r elbow
Cozen's + at R elbow
Tinel's tap - in R elbow and wrist
Finklestein's test + on wrist (he actually performed Eichhoff's test not finklestien's)
Phalen's - on R wrist
Circumference of upper exteremity musculature was measured bilaterally Above elbow 31 1/2cm, below elbow 27 cm both bilaterally.
Summary:
the total upper body impairment was 14%. Table 3 (page 20) converts this to 8% body as a whole person. This becomes the final whole person impairment rating. It should be noted that this injured worker would benefit from Periodic care in the future in order to maintain the biomechanical improvement she has achieved under her treating doctor's treatment plan.
I will be seeing my treating Dr on Thursday, and following up with a face to face for the first time since I hired her over a year ago, with my attorney. I think, if it is all played out right, I should have my claim accepted no later than the end of May. Especially since we found fraud committed on the original Employers' first report of injury. And it just wasn't one little error, but three. The adjustor has already filed a new report of injury (this one has the actual reported date of first injury on it) and by the end of the month, instead of having a mess of three claim numbers for the same injury, it will all be under just one that the court will accept. Heck, I may find that come Thursday afternoon when I meet with my attorney that I have an accepted claim and be getting a check soon ~LOL~ as if WC moves that fast !!!
Will let you know what happens at the Dr's and attorneys on Friday.
Angel ^j^
