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AMA Guide to Permanent Impairment, 6th edition
#21
It was my opinion, that I did answer your AMA questions. In fact I had informed you of others with the same surgery you had with-out a Fusion were rated only at 5%. Then I also Posted what was writen in the AMA 5th Edition for you.

The Ratings can be adjusted to the nature of the injury, and Nerve damage, plus a few other factors. It's not just a fixed rating, for the medical facts in each case can adjust the ratings slightly is all. All depends on what's going on with muscle, nerves, DRE/ROM and so on. Also the finding facts of a properly performed FCE Evaluation can help with a AMA rating.

Then I had thought in this thread the subject then changed, making me then think you were not seeking anymore AMA information.

I don't think Doctor's make good Attorney's, and Attorney's don't make good Doctor's. They each have a role or path they must follow. And yes, everyone pays for their Attorney's, but mostly never paid till the case is settled and then the Attorney obtains a percentage of the settlement amount. No one works for free.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#22
I just didn't understand your answer is all, just read it differently. I didn't mean the subject to change, but questions were asked and I answered them. I tried to find copies of the AMA guide that might answer some of my questions, but they were all too expensive. I am hoping that perhaps the library might have a copy.
 
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#23
I doubt anything but a medical library will have an AMA GUides so try a local medical school. What would you like to know though as I hapen to have access to a 5th ed and I'll see if I can find an answer if it's different than the one I already gave you.
 
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#24
Law school library. I bought my copy at Amazon.
 
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#25
I am trying to find out if it is realistic to apply for a higher rating. As I said, I was rated at 12% which is standard for the discectomey, but the MMI doctor didn't list the surgeons reasons for a higher rating of at least 15%. I was told that the AMA does not take into account any pain levels or ROM. I have a high pain level, and limited ROM. Even the MMI doctor said that I could not be doing any job that meant being tethered to a chair for more than a half hour at a time...need to be moving about, but again to avoid frequent or repetitive truncal flexion/extending or twisting. I just want to see some wording in the AMA that considers options to a rating. Like nerve damage, muscle weakness, etc.

Also, so far I've had two episodes of "relapses", which I am told to expect for the rest of my life, in the last 6 weeks. Each lasting a week at least and had me bed ridden...or at least literally on my back. How does that figure into a working situation? Surely there must be some limitations as to what employer would be willing to hire an employee who may be off on such a regular basis.

All I saw of the AMA guide, was that section that stated what a discectomy would rate. I just had the feeling that the MMI doctor felt she was restricted by that as well. Though she didn't actually say so.

I know this is somewhat repetitive. I just want to look at that section and see what is written so that I can figure out what is going on. Has anyone here had one rating, and then had it changed in their favour?
 
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#26
I had one rating from my treating doctor of 32% and then sent to a IME from the IC because it was to high. The surgeon that did my IME only went by my EMG result of " mild carpal tunnel" and made his rating on that. He did not consider neuropathy in his notes. This of course was the chosing of the IC doctor to make his opinion which the court found more credible.

If you got a 12% rating, I really do not see you getting it much higher, and if you do the IC will dispute it anyways. At least that is what my opinion is from experience. The higher the rating, the more they will dispute. I think if my doctor put down 15% instead of 32% I might not of had to go for a hearing in front of the labor board and it would of been agreed upon right then. But because it was way out of the ordinary, it was disputed. If I were you, I would take the 12% and at least if anything happens you will still have medical care if needed and if they are agreeing to pay for your medication that is good also. 3% is not going to make to much of a difference.

I did not dispute my 10% for that reason. I knew that I would never get the 32% for my arm. My main thing was I wanted to still have medical coverage. I never did have a lawyer, so I did not have to pay any percentage to a lawyer. I am back to work full time although very difficult to work, I do it to stay busy and keep my mind off the pain and be in society with other people. I have found it has helped my self esteem tremendously.

It is something that YOU will have to think about. Is it worth going for another 3%, or accept the 12% and find a job within your restrictions and still be able to get the medical care you need if needed. THat in itself is a big part of taking care of your injury that is work related. I am lucky my new job has health insurance and they pay for my medications needed for PM in order to work everyday. WIthout that I would definitly be disabled.
carpal tunnel recurrence/ neuropathy / RSD.
1/29/07 injury date. Permanent. PIR settlement 8/4/08 10%
 
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#27
Okay. I understand you wish to see for yourself.

I did post here back a few post what the AMA 5th edition listed for a discectomy. It was like 3 % higher then the 6th edition. I posted that.

The fact is, a discectomy, doesn't rate high because a Fusion will rate higher. This is a fact. The AMA guides are set-up incase a future surgery is needed then the rating changes to a slightly higher Rating.

The example is, if your rating was higher and at the fusion level, then when you have a fusion, the rating couldn't change much.

I think that explains why the AMA and medical teams rate discectomy lower then a Fusion is all. I'm trying to explain it as it works for you, but I'm not buying the book neither. I did ask an Attorney about this information, and I'm re-peating it back to you is all. What better place to get information when your not sure is to ask a Attorney that does know.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#28
The AMA GUides is an impairment assessment and impairment is a medical definition as opposed to Disability which is a social assessment.

A single level discectomy under 5th ed, which doesn't change much under Spine evaluation in 6th ed, is assessed as a DRE III in the range of 10-13 % WPI UNLESS there are circumstances that would increase impairment. A tear does not UNLESS it has led to arachnoiditis.
Nothing you have said leads me to believe there is any basis to apply for increase - but I suppose it doesn't hurt to ask
 
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#29
A single level cervical fusion under the 5th would automatically place the IE in the DRE 4 catagory. A fusion will satisfy the requirement for motion segement integrity.
 
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#30
Ok I understand all of that. My problem is this. The reason I was doing this job as a personal care worker in the first place is because I am a qualified nurse in England, but the qualification does not transfer in this country. Most every skill I have to my name is British and most, including something as simple as using a telephone exchange system, is entirely different. I would need some sort of on the job training, or outside training to get me up to speed in this country. Most employers here, all that I've spoken to, don't do that. They want someone right on the spot. I do have medical terminology, but most of that is spelled differently, used differently, or different alltogether. I do have phamacology, the same holds true fro this....all medications are different names over in England. Even in the business field, things are different. So I did the job I knew I could earn the most in....private client, and housekeeping privately. Now, I can do neither. I can't even clean my own house without causing the back to have problems, so I have been told don't. So my prospects of getting a job quickly are very dim. The w/c say I won't incure any wage loss, thats if I find a job. But I know from experience, that finding a job won't be all that easy at all. The job I did was for 39 hours a week, and paid just enough to pay the mortgage. Then I had another private client, who died just four weeks prior to my injury...so w/c don't that into account. That was for 20 hours a week. Then I had two housekeeping jobs, which don't count to the wc since it was paid by cash in hand. So when I was working 60 a week to pay my bills, I only get judged on 39. And to add insult to injury, I was paid according to my last few weeks payroll, and my private client had spent most of her time away for the holidays........and training for her service dog. So I was well down. Makes no difference to w/c.

So the extra 3% would get me the training that I needed to upgrade my nursing level here, or at least put me in a medical field...like medical assistant, or admissions. So I know it looks like I am pressing the point with them....they will not take into account what I was doing in order to just pay the bills. Montana is already a low paid state. And I have no doubts whatsoever, that whatever job I do, I will have to work the same long hours in order to make it.....60 hours. How do I manage that with my back and legs giving way all of the time, I don't know.

Anyhow, I know I've laboured this thread too long now, so I will try to find some other way of dealing with this. Thanks for your help.
 
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