impairment rating

[jstadfrntpn]

IC sent me for an IME before they approve spinal fusion, IME Dr. said it IS nessessary. He also said my impairment rating now is 15% and after the surgery it will be %25. I have heard the terms Impairment rating, could someone tell me what it is and what it is used for?

[Still in Limbo]

An Impairment Rating is Used to Calculate the Restrictions, if any You will have in the Workplace, and also for Settlement Purposes. My Suggestion, Immediately after You Receive the Dr.'s Final Impairment Rating, Get One of Your Own, from a Qualified Dr. in the Same Field. It May Cost a Few Bucks, but it Helps to Keep Everyone Honest!! Best of Luck on Your Surgery, I Hope All Goes Well!!

[1171]

that should be troubling.
impairment ratings are used by many states to determine additional benefits after recovery is complete. the greater the permanent impairment, the higher the rating, and the more additional payments are available to help you transition back into the workforce.
Treatment that leaves the worker worse off then before should be weighed very carefully. maybe even consider getting another opinion from a specialist you or your regular doctor choose.
"Permanent Partial Disability Benefits – This benefit is payable to the employee for a permanent disability resulting from an on-the-job injury. It is payable based upon a percentage given by your authorized treating physician in accordance with current AMA Guidelines. The percentage is calculated by a formula that contains number of weeks assigned by the State Board X the percentage rating X the Temporary Total Disability rate. Not all injuries result in ratings assigned by a physician"
http://sbwc.georgia.gov/vgn/images/porta...ndbook.pdf

[sparkey]

I have to disagree with 1171. Your statement of " it is payable based upon a percentage given by YOUR authorized treating physcian in accordance with the AMA guidelines".

It is NOT based on what your treating physcian that is in accordance with the AMA guidelines but by what the IC co. IME doctor says your percentage should be. Not always do you win the percantage of your own treating physcian, but can have some doctor that is paid alot of money by a IC to say that your injuries are not as bad as your treating physican says they are.

It is whoever is more credible the court will go by. Unfortunatly the court of NH where I went, the doctor was used many times for cases ( which means he made a fortune ) in lieing for the IC's to lower the ratings.

I believe that the IW is definitly not getting a fair rating, when their own doctor that took 1 1/2 hours, and is AMA guideline certified and a OCC MED doctor cannot be more credible than a sports injury hand surgeon that does not even have AMA guideline Certifications listed in his credentials ,and only took 10 mins. to look at me and ask questions. This is a disgrace to the IW and something needs to be done about this.

[jayne]

sparkey Wrote:I have to disagree with 1171. Your statement of " it is payable based upon a percentage given by YOUR authorized treating physcian in accordance with the AMA guidelines".

It is NOT based on what your treating physcian that is in accordance with the AMA guidelines but by what the IC co. IME doctor says your percentage should be. Not always do you win the percantage of your own treating physcian, but can have some doctor that is paid alot of money by a IC to say that your injuries are not as bad as your treating physican says they are.

It is whoever is more credible the court will go by. Unfortunatly the court of NH where I went, the doctor was used many times for cases ( which means he made a fortune ) in lieing for the IC's to lower the ratings.

I believe that the IW is definitly not getting a fair rating, when their own doctor that took 1 1/2 hours, and is AMA guideline certified and a OCC MED doctor cannot be more credible than a sports injury hand surgeon that does not even have AMA guideline Certifications listed in his credentials ,and only took 10 mins. to look at me and ask questions. This is a disgrace to the IW and something needs to be done about this.

if everyone was able to take a video of their IME's I bet alot of Docs would no longer do them

[frustratediw]

sparkey Wrote:I have to disagree with 1171. Your statement of " it is payable based upon a percentage given by YOUR authorized treating physcian in accordance with the AMA guidelines".

It is NOT based on what your treating physcian that is in accordance with the AMA guidelines but by what the IC co. IME doctor says your percentage should be. Not always do you win the percantage of your own treating physcian, but can have some doctor that is paid alot of money by a IC to say that your injuries are not as bad as your treating physican says they are.

It is whoever is more credible the court will go by. Unfortunatly the court of NH where I went, the doctor was used many times for cases ( which means he made a fortune ) in lieing for the IC's to lower the ratings.

I believe that the IW is definitly not getting a fair rating, when their own doctor that took 1 1/2 hours, and is AMA guideline certified and a OCC MED doctor cannot be more credible than a sports injury hand surgeon that does not even have AMA guideline Certifications listed in his credentials ,and only took 10 mins. to look at me and ask questions. This is a disgrace to the IW and something needs to be done about this.

1171 provided the information as it is stated by the Georgia system. I do not disagree with your assessment of the system as it pertains to your case. I do think it is necessary though to remember that not all states operate the same. The IME process as you refer to it for NH for instance is not the same as it is in California, a system I am familiar with. It may or may not be the same for other states.

[stiffnecked]

The difference between the two rating is quite simple. The 15% would be a DRE catagory 3. The 25% is for a DRE catagory 4. Like it or not when you have spinal fusion surgery that automatically bumps you up to the next catagory. A two level fusion would probably be more as it would need to be rated using the ROM method and that also includes evaluating nerve impairment.

[jstadfrntpn]

so at some point will i be compensated with respect to the impairment rating? this was done by the IME, payed ofcourse by the
IC. Right now i am getting regular ttd checks, and the surgery is scheduled in a couple of weeks. I just wanted to know what the 25% impairment rating means for me, By the way i do not plan to settle my case bc it is a back injury.

[stiffnecked]

I would assume so. While you can you should look up the WC laws for Georgia. That way you can get the info straight from the horses mouth.

[1171]

the statements in my prior post that are within the quotation marks are taken directly from the link provided to the georgia work comp handbook and are not my personal opinion.
frustrated is very correct: the experience of any one poster on this board is generally unique to their states system and is not necessarily an accurrate depiction of how another claim will be handled under a different states rules.
That certainly doesn't invalidate anyone's opinion or experience but it is a caveat that needs to be made to those who are relatively new to work comp insurance.