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Permanent Impairment

Why is the Guide for permanent impairment assessment so hard to access?! I can't find any information on ratings online anywhere, I feel almost forced to buy the book for $400 but bugger that!

Would anyone have any idea what kind of permanent impairment percentage my injury would be, this is my story:

I injured my back in Aug 2009, I was forced to continue working until I was in so much pain I refused to work any longer as I was physically unable to! I couldn't put my shoes or underwear on! I remember hurting myself trying to get out of bed one day, I started crying and had to calm myself down to stop because the jiggling motion of me crying was causing too much pain! Besides the excruciating pain, I had loss of strength in my left leg, unable to lift my leg onto the clutch to drive to work, I started to get foot drop and my toes started to curl (this is all on my left side). I started to get strength back in my leg (as the bulge moved down my spine) but then pain turned into numbness in Dec 2009 - left bum, left side of my vagina, back of thigh, heel, along side, bottom and top of foot are all numb, and are still numb today.

I had a massive bulging disc at my L5/S1 (20mm x 11mm x 14mm) which was affecting my L5, S1 and as far down as my S2 nerves. I was also experiencing bowel and bladder dysfunction and was diagnosed with partial cauda equina syndrome, I had surgery in Feb 2010. I was extremely lucky (all the docs keep telling me) that I gained control of my bladder and bowels after surgery (still can't empty like I use to but at least I dont' have to self-cathaterise myself every 4 hours!) but I still have all the numbness with subsequent problems.

Because of the nerve damage/numbness I now can no longer orgasm, which has obviously caused major pshycological stress/depression as well. I was told to expect muscle wastage in the areas of numbness, and I have noticed wastage particularly in my foot - it looks hollow and slightly deformed (slight toe curl, claw foot), the muscle wastage is quite obvious you can clearly see it with your eyes. My calf and thigh are in the same boat and over time will become more noticable like my boney foot!

My case is currently closed because they can't do a permanent impairment assessment until 12 months after surgery. I have to write a letter to have the case re-opened and re-assessed in Feb 2011.

I've heard that if the permanent impairment % goes over 20% that you can accept compensation and sue the company. Does anyone have any idea what % my case would be likely to get?

Any help would be much appreciated.
Hi Lil,

Here is one site you might find useful, 'Impairment Use of the AMA Guides.


It covers guidelines per state. But frankly it's like the darn tax code or Obama's health care law. Figuring out those figures is beyond me or I would imagine most people.

Good luck
most impairment guides are copyrighted by third party developers.
some states create their own and they usually make them available on line.
Obviously the AMA guidelines are not state developed and they expect to get paid for their work.
each state has their own rules. that's why this site requests that posters give their state

doing an impairment rating is complex and can't be done thru a message board whether the rating guide is known or not.
a lawsuit is a civil law term and forbidden under workers comp.
you can however get an award for additional disability payments from the comp court.
"Footer/signature" used in all my posts:
........Each state has their own comp system. We need to know your state to provide accurate information.........
Sorry if I missed it but do you have a lawyer? If so that is a good place to ask questions. As 1171 said you can not file a lawsuit for a work comp issue. And wc does not pay for pain and suffering
Hi, thanks for the replies. I'm actually from Queensland, Australia however I know that we use the AMA guidelines for assessment (number 4 I think). I had a chat to a lawyer last year but will have to contact one soon as my assessment is coming up in Feb 2011 (my case is currently closed as my condition is considered "stable"). The laws here advise that if the permanent impairment % assessment is 20 or more then you can take the offer and sue the company, but if it's under 20% you can only do one or the other, not both.
you should be able to find the AMA guides in a medical library or at a doctor's office.
maybe one of your comp boards has a copy you can review.
"Footer/signature" used in all my posts:
........Each state has their own comp system. We need to know your state to provide accurate information.........
Hi Lill, i too am from Qld Australia. In September 2010 I had spinal fusion at L4 and L5 with titanium hardware, and complications of permanent foot drop due to S1 nerve damage. (a screw was misaligned and a second surgery was done 1 day later to remove and replace offending screw that was impinging/pinching my S1 nerve root)I too injured myself whilst working.

Workcover Qld uses the Table of Injuries schedule 2 and the methodology of the AMA Guides (it is the 4th edition), when undertaking a permanent impairment assessment. It's not really something that we ought be concerning ourselves with, as apart from wanting to empower ourself with a bit of knowledge of how the Workcover's Medical Practitioner will prepare their permanent impairment assessment report, (which if you don't agree with the % given you can take it to our Medical Assessment Tribunal to reasess), there really is nothing we can do about it. This process is still a statutory one, not a civil one. Even taking it to the Medical Assessment Tribunal is not a civil case.
I have no idea why you believe you had to wait 12 months after surgery, before a permanent assessment was undertaken? It is more common that it is the 6 month mark, when Workcover begin the process of it. It is Workcover that are in control predominantly, of when it is done.
I note you say your 'case is closed as it its considered stable'. If that be the situation, you would have already attended a medical asessment for permanent impairment assessment, and been given a %, and offered a settlement amount. Workcover only 'close' the claim after permanent impairment assessment process has been completed and an offer made. Perhaps what you meant was you've reached the end of your statutory claim period, because you've been assessed as reaching maximum medical treatment and in the eyes of Workcover your injury is stable and stationary, so the next and final area of this process, is to attend the permanent impariment assessment with their Medicial Practioner?

If you are paying into a Union you could contact them and see if they'll refer you to one of their Solicitor Firm's for free legal advice, or seek a Lawer that will help with this final statutory law area. Not all deal with this so you'll have to ask, and many deal with civil suits for neglegence, once the statutory process is completed.

Another thing is have you considered looking into your Superannuation fund as you may have coverage for permanent and total disability insurance? If so, you can seek a Lawyer to help claim for this, for your inury too. This is different to claiming neglegence by your Employer.

Yes in Qld if you are assessed as permanently impaired 20% or more, you can accept Workcovers offer and sue your employer for neglegence. Do not sign anything however, until you get a lawyers opinion. Being able to sue for neglegence at the hand of your employer is not as simple as it may seem. Most i am told by my Lawer do manange to settle and not go to trial, unless it is in the Millions of compensation sought.

I am confused with your post "My case is currently closed because they can't do a permanent impairment assessment until 12 months after surgery. I have to write a letter to have the case re-opened and re-assessed in Feb 2011."

I hope that i have been of some assistance to you however.Shy

Hi It's been 3 weeks since my ACDF at c5/6 with titanium plate and screws. I feel I'm been pushed to just go back to work and get no lump sum for this? Would I be entitled to a wpi?, also shall I ask for an wpi assessment or is it to early? Thanks
(06-07-2011, 11:35 PM)Bilistik Wrote: Hi It's been 3 weeks since my ACDF at c5/6 with titanium plate and screws. I feel I'm been pushed to just go back to work and get no lump sum for this? Would I be entitled to a wpi?, also shall I ask for an wpi assessment or is it to early? Thanks

you should start your own thread so as not to confuse other readers.
any information depends on what state laws covers your claim. without knowing yours we'd be guessing.
"Footer/signature" used in all my posts:
........Each state has their own comp system. We need to know your state to provide accurate information.........
Hi 1965

Thank you so much for your post and yes, you have helped a lot! My goodness it sounds like you've been through a lot.

Well, a lot has happened from when I posted that but to answer your question first, I had to wait 12 months because of the neurological issues with numbness. They say feeling normally comes back within in days or weeks, sometimes months. The Doc said, give it 12 months, if your feeling isn't back by then then it's permanent which is why they held off doing the PIA to see if it was permanent or not. Anyway, it's permanent. Along with that came all the fun stuff with numbness/nerve damage - muscle wastage in my foot, cramps (legs and feet), uncontrollable muscle twitches, phantom touches, electric shocks.....

My first surgery was in Feb 2010 - I was also diagnosed with partial cauda equina syndrome. The first herniation was 20 x 11 x 14mm and affected L5 to S2 nerves more so on my left side. Anyway, since then, I've had more surgery in Nov 2011. I started having constant pain down my right leg (which use to be my 'good' leg) about a year or so after the first surgery. It was the same L5/S1 disc, what was left of it bulged out again. The second time it bulged it was 10 x 12.6 x 11.9mm and affected again the L5 to S2 nerves more so on my right side this time. They went in through the stomach for the fusion, because it's easier and I've already got scaring at the back from the first surgery (discectomy). Bone was taken from my hip for the fusion and it's healing up nicely. I now have the cramps and twitches in both legs and feet.

This all started when I was 28, I'm 31 now and haven't had children. I worry about the whole process of pregnancy and other things like being unstable on my feet when I'm older. Last time in hospital I was surrounded by 60 - 80year old women who'd smashed their hips from tripping over (worst nightmare for anyone but esp. an oldie when your bones just shatter). If I find it hard to stand without cramps now.....or even trying to get them out is a workout - I'm telling you, my muscles go rock hard! Seriously, I reckon I could crack a nut on my calves when they're in full cramp. How will I go when I'm 70?

Anyway, I never got to complete a PIA the first time round because of continuing issues and need for further surgery but I'm having one tomorrow. And 1965 you're absolutely right, the whole PIA process isn't something I should have been concerning myself with. I think the first time round I was just getting conflicting and unclear information from Work Cover, I was confused, scared and felt like it was all out of my control. Which as you said, it is! Thank you for taking the time to write your post because you've been through the whole process. I know I googled everything on back surgery etc. when it all first happened and most relate to pre-op scared patients or horror stories. So thanks for taking the time post op to tell me your experience.

Would you mind if I contacted you personally? And if so how would I go about doing that? I know I'm Gen Y and am suppose to instinctively know all that stuff but I don't really post on sites like this.

Thanks again


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