Texas impairment rating, any info would help

[froglett]

In December I fell, injuring my ankle, calf, knee, lower back, and shoulder. In March, I went for an impairment rating exam, with a doctor that my treating doctor sent me to that is registered to do these ratings, twc also sent me to a different doctor to get an impairment rating. They both agreed that I had not reached mmi, and that I should have an mri done. The mri showed early tendinitis, fluid, and itramuscular tears. In June, my dr again sent me to have an impairment rating exam. Using the correct manuel (fourth ed.) he gave me an impairment rating of 15. All of these exams took over an hour, with lots of measurings taken. I got a letter from texas workers comp saying that I had to see their designated dr. I could not see the one they sent me to before because of scheduling conflicts, so the sent me to another dr. (who immediately pushed my appointment back 2 weeks. ) When I got there, this designated dr. was a former obstitrician and now a family practitioner who rented a room from a chiropractor. He spent about 45 minutes telling me about himself and how the wc system works. He spent about 10 minutes examining me, using a plastic ruler and a protractor. Today I went to my regular dr and was told that he had given me an impairment rating of 0! That he completely disregarded the two drs reports, and the mri results and classified it as a simple sprain. When he examined me, I had a huge swollen not on my ankle, he did not even measure my ankles, just my calfs. My dr said that he would dispute this. Does anyone know what might happen now, and a time frame? I was shocked, a zero impairment? Even though the insurance company disputed the 15, I was told they dispute everything over a 14, they were continuing to pay me to a 5 before this. A 0 ??

[1171]

unless it's disputed the DDs opinion will carry greater weight with the commission. you'll need corroborating medical opinion to support a finding other then the DDs.
you can find out more from office employee counsel
http://www.oiec.state.tx.us/
doctors in texas most often use the AMA guides to rating Impairment.

[froglett]

Thanks, my doctor is going to dispute it for me immediately. I have my mri, and two other doctors opinions, plus the first designated doctor they sent me to. I have never heard of anyone getting a 0 impairment rating before, though. The doctor that did the first one of 15 is registered with the state and claims he followed the correct guidlines.

[1171]

texas allows treating physcians to be present during DD exams. that can help avoid disputes.

[froglett]

There is no way my treating doctor could be present. I got the report today from the dd. He based his findings on the fact that I could sit comfortably while we talked, and was able to lift my leg and show where the problem areas were. I told him that the pain is worse when I have to stand or walk for any lengths of time. I am so upset. The exam lasted about 10 minutes, after he spent 45 minutes talking about his credentials, which really had nothing to do with my injury, he was a family practitionar, slash ob. I cannot even take my daughter to the mall without a painful night, swelling, and a pronounced limp the next day. This guy is an idiot.

[1171]

i wish more would complain about these issues with the doctor when the decision is in their favor. It's easier for the system to dismiss such complaints when the worker doesn't like the opinion.

[froglett]

I am just amazed that he gave me a zero. The doctor my treating doctor sent me to gave me a 19 supposedly using the same 4th edition guidline manual. The new designated dr. even mentioned my ankle was swollen, and this is 7 months after the injury. He said that he based the impairment rating on the fact that I could sit there and discuss everything with him comfortably, and lift my leg by myself onto the table to point out where the pain was. I have never claimed that it was painful to just sit. It is walking, standing and driving that causes pain. And he completely disreguarded the mri findings that said there was tears, fluid and tendinitis...that rates a 0? I really thought the rating would be lower than the other drs, even though he insisted that the guidlines supported the 19, but I never would have dreamed a 0.

[Lilly]

Froglett... Definitely Dispute it, This is normal protocol for IC to keep sending you to different doctors to achieve a low or zero impairment rating...or until IC is satisfied with the final number, to get out of paying you, or giving you the medical treatment you deserve to get well. I'd lawyer -up if you haven't already!
take care & Good luck, Lilly

[froglett]

I hope I can do something about it. My doctor advised waiting until he disputed it before hiring a lawyer, and that an ombudsmans would help me at first. I am just surprised they can even give an impairment rating of zero, and still give an impairment. He said several statements in his report that are not true. He said that my ankle moves with no clicking or popping, I feel the clicks and pops whenever I rotate it. I quit my job to go to work with my husband. He said I do this with no physical restrictions. True, when I am at the computer sitting down, no restrictions, but when I have to drive for him, it hurts. Any prolonged standing or walking makes my leg swell, how can this not be a restriction? He said," she does complain of just pain in her lower back occasionally, but her exam was otherwise unremarkable." Just pain? He said that I had no pain in my neck whatsoever during his exam. True, but I also told him that the neck pain along with some of the other problems I was having (includining swelling that was shown in the mri) occured mostly at night after a hard day. The amount of problems directly in conjunction to my activity level. He mentioned slight swelling of the gastrocnemius muscle, he did not mention or measure the swelled knot on the side of my ankle at all.