5% Whole Person Impaired - Printable Version
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5% Whole Person Impaired - Paulie112099 - 05-24-2008 04:08 AM
I'm new here. I was injured with a spranged back months ago. The Doctor who gave a second opionion of me put it down in document over and over that I am 5% Whole Person Impairment. I have no idea what that means. Does it mean my workers com is going to send me a check every month?
RE: 5% Whole Person Impaired - Bad Boy Bad Boy - 05-24-2008 08:24 AM
No, it means the doctor rated your injury is all. If you wish a settlement, you may need to seek that out yourself. The insurance carrier doesn't always reach their hand out with money.
RE: 5% Whole Person Impaired - frustratediw - 05-24-2008 01:36 PM
You don't say what state you are in. Each one is different as to how things are handled. Provide that info and you might get better answers.
RE: 5% Whole Person Impaired - Paulie112099 - 05-24-2008 02:00 PM
I'm in the State of Texas. But what is next that I should be doing?
RE: 5% Whole Person Impaired - bethsha211 - 05-24-2008 11:09 PM
Hey Paulie,I am from Texas and may be able to help you.
Did you file a claim for your injury with your employer?
If so, have you gone back to work or are you under restrictions?
Did you go to a doctor for your injury and then to one that worker's comp. sent you to get the 5% rating? If you just got the 5% from a treating doctor,then you might need to find out if you are MMI.
Have you talked to the insurance company's adjuster about the 5% rating?
If I had more information,then I could answer some of your questions. One thing I can tell you is that in Texas 5% whole body = 5 x 3 weeks = 15 weeks of whatever your wages were 13 weeks prior to you getting hurt at 70 % of that total.
RE: 5% Whole Person Impaired - Paulie112099 - 05-25-2008 02:19 AM
Was injured in January. Sent to the Hospital, came back to work about 3 or 4 days later. Been working full time since then. Workman's Com had been paying my medical bills. Recently they asked me to see a Doctor for a second opinion. And the Doctor looked over me, said that I was not fully recovered, but not someone that needs surgery. And he sent me the evaluation where it say's 5% Whole Person Impairment over and over. So I don't know what this means and what I am supposed to be doing next.
RE: 5% Whole Person Impaired - Deb - 05-25-2008 11:39 AM
I am in Texas too. Since you do not have an attorney one of the ways to get answers to your questions is through an Ombudsman (see below). The initial consultation with an attorney is usually free too. You can also click on "State Info" at the top of this website and then click on "Texas" and read about the laws as they pertain to our state. If you have any further questions please don't hesitate to ask and we will try and help. Please let us know how things go for you. Deb
WHAT IS AN OMBUDSMAN?
An Ombudsman is a specially trained employee of the Office of Injured Employee Counsel (OIEC) who can assist you if you have a dispute with your employerÃ¢â‚¬â„¢s insurance carrier free of charge. Each OIEC ombudsman has a workersÃ¢â‚¬â„¢ compensation insurance claims adjuster's license and has completed a comprehensive training program designed specifically for OIEC ombudsmen. Ombudsman services are provided at no cost to injured employees.
The ombudsman can answer questions you have regarding your dispute (by calling 1-866-EZE-OIEC 1-866-393-6432). And, upon request, the ombudsman can:
Help you prepare for benefit review conferences;
Help you prepare for benefit contested case hearings;
Attend benefit review conferences and benefit contested cases hearing with you and communicate on your behalf with the parties, and;
Help you prepare appeals and answer carrier appeals to the appeals panel of the Texas Department of Insurance, Division of WorkersÃ¢â‚¬â„¢ Compensation.
RE: 5% Whole Person Impaired - bethsha211 - 05-25-2008 02:38 PM
Paulie,I would suggest that you call as Deb said and find out what the status is with your case and what you need to do.If 5% is your rating from designated doctor then the insurance company needs to pay you for 15 weeks impairment rating,but it will be given to you once a week until it is paid out.
RE: 5% Whole Person Impaired - popeye - 05-29-2008 09:09 AM
When you have reached mmi, maximum medical improvement, you will receive an impairment rating, which is what the 5% is. You will be paid 3 wks of workmans comp benefits (70% of your weekly salary, but there is a roof limit on it) for each percentage point. Example: you make $500 a week, times 70% is $350 times 3 is $1050 times the 5% is $5250. If you have been back to work for 90 days at the same rate of pay, you can request that at a lump sum, if not you will receive $350 for 15 weeks. Now, that said. If you have not reached mmi, which if the dr said you are not fully recovered, that means you have not reached mmi, and the 5% will not get any higher, it could get lower with therapy. Do you feel like you can get better? If not, request the mmi exam from a designated dr, get the impairment rating to your dr, if they agree to it (if it is a dr of your choice that is registered with TWC to do the exam, if it is their dr, I think they have to agree) They have to send you a check within 5 days. I am not sure how long for a lump sum, but probably not much longer.
RE: 5% Whole Person Impaired - Bad Boy Bad Boy - 05-29-2008 12:34 PM
I'm confused to the injury as I looked this over 1 more time.
Stated a Sprain to the Back.
Are you saying you have a sprained muscle?
Were there any X-rays or MRI's taken of that area of the back (spine)?
What medical treatment have you obtained?
Were you taking any medications, and are you still?
Have you ventured out to obtain your own Medical opinion from a doctor of your choice, which you will have to pay for, but well worth good medical advice?
How is your back doing as of today?
If you still hurt, and in pain, you do need to keep seeking proper medical attention. And if that is the case seek out a Neurosurgeon.