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WC C-4.3 form headache - Printable Version

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WC C-4.3 form headache - Nadpalm1 - 01-19-2021

Where to begin...
First I am in NY. Injury was 2013. Surgery, PT, acupuncture, fusion, spine stimulator... to keep it short n sweet. Still in chronic pain 365 days 24/7. I had a court date the beginning of December. The judge sided with the ins company and decreased my weekly payments. I have to have my doctor fill out a C4.3 form (Maximum Medical Impairment form). My pain management doctor can’t fill it out because he doesn’t have the equipment to do the testing. My Surgoen said the same thing. Ok fine- so I need to find someone who can. More work on my end, wonderful. But my problem is this- HOW DID THE IME DOCTOR COME TO A CONCLUSION IF HE DIDNT HAVE THE EQUIPMENT TO DO THE TESTING EITHER. How did he conclude that I was at “partial permanently disability”????? Believe me- I don’t want to be called “disabled” but I can’t go back to work- and now they have cut my income. Any suggestions????
Thank youuuuuu


RE: WC C-4.3 form headache - goingback - 01-19-2021

(01-19-2021, 06:25 PM)Nadpalm1 Wrote: Where to begin...
First I am in NY. Injury was 2013. Surgery, PT, acupuncture, fusion, spine stimulator... to keep it short n sweet. Still in chronic pain 365 days 24/7. I had a court date the beginning of December. The judge sided with the ins company and decreased my weekly payments. I have to have my doctor fill out a C4.3 form (Maximum Medical Impairment form). My pain management doctor can’t fill it out because he doesn’t have the equipment to do the testing. My Surgoen said the same thing. Ok fine- so I need to find someone who can. More work on my end, wonderful. But my problem is this- HOW DID THE IME DOCTOR COME TO A CONCLUSION IF HE DIDNT HAVE THE EQUIPMENT TO DO THE TESTING EITHER. How did he conclude that I was at “partial permanently disability”????? Believe me- I don’t want to be called “disabled” but I can’t go back to work- and now they have cut my income. Any suggestions????
Thank youuuuuu

The IME is paid by the carrier, the IME will say what they are paid to say. Your doctor should be able to send you for functional capacity evaluation. They will perform the testing to complete C4.3 . Did you apply for SSD? They test you , if you are found disabled it might help you with WC even though WC is state and SSD is federal .


RE: WC C-4.3 form headache - 1171 - 01-19-2021

The point at which a patient is considered to have reached Maximum Medical Improvement is not the result of objective measurements. It generally a medical opinion based on the physician’s experience and judgement.
“ A finding of MMI is based on a medical judgment that (a) the claimant has recovered from the work injury to the greatest extent that is expected and (b) no further improvement in his/her condition is reasonably expected.”
On the other hand the amount of functional loss that has occurred at that point is measurable.
There are very detailed guidelines for evaluating those loses.
http://www.wcb.ny.gov/content/main/hcpp/ImpairmentGuidelines/ImpGuideOverview.jsp


RE: WC C-4.3 form headache - Nadpalm1 - 01-22-2021

(01-19-2021, 08:37 PM)goingback Wrote:
(01-19-2021, 06:25 PM)Nadpalm1 Wrote: Where to begin...
First I am in NY. Injury was 2013. Surgery, PT, acupuncture, fusion, spine stimulator... to keep it short n sweet. Still in chronic pain 365 days 24/7. I had a court date the beginning of December. The judge sided with the ins company and decreased my weekly payments. I have to have my doctor fill out a C4.3 form (Maximum Medical Impairment form). My pain management doctor can’t fill it out because he doesn’t have the equipment to do the testing. My Surgoen said the same thing. Ok fine- so I need to find someone who can. More work on my end, wonderful. But my problem is this- HOW DID THE IME DOCTOR COME TO A CONCLUSION IF HE DIDNT HAVE THE EQUIPMENT TO DO THE TESTING EITHER. How did he conclude that I was at “partial permanently disability”????? Believe me- I don’t want to be called “disabled” but I can’t go back to work- and now they have cut my income. Any suggestions????
Thank youuuuuu

The IME is paid by the carrier, the IME will say what they are paid to say. Your doctor should be able to send you for functional capacity evaluation. They will perform the testing to complete C4.3 . Did you apply for SSD? They test you , if you are found disabled it might help you with WC even though WC is state and SSD is federal .


Thank you for your response- I do have SSD already. And they didn’t do functional capacity test either. I went yesterday to have the test done for the C 4.3 and it was hell, so much pain after completing it.


RE: WC C-4.3 form headache - Nadpalm1 - 01-22-2021

(01-19-2021, 08:45 PM)1171 Wrote: The point at which a patient is considered to have reached Maximum Medical Improvement is not the result of objective measurements. It generally a medical opinion based on the physician’s experience and judgement.
“ A finding of MMI is based on a medical judgment that (a) the claimant has recovered from the work injury to the greatest extent that is expected and (b) no further improvement in his/her condition is reasonably expected.”
On the other hand the amount of functional loss that has occurred at that point is measurable.
There are very detailed guidelines for evaluating those loses.
http://www.wcb.ny.gov/content/main/hcpp/ImpairmentGuidelines/ImpGuideOverview.jsp

I completed the test yesterday. I can’t even imagine how they can judge disability based on the things they asked me to do. This whole process is so ridiculous


RE: WC C-4.3 form headache - 1171 - 01-22-2021

(01-22-2021, 05:19 PM)Nadpalm1 Wrote: [quote='1171' pid='171467' dateline='1611103555']
I completed the test yesterday. I can’t even imagine how they can judge disability based on the things they asked me to do. This whole process is so ridiculous

there are a number of different approaches to try and quantify the long term effects/severity of an injury/condition on an employee. some states try to capture future earnings loss; others try a combination of wage loss and disability ratings. in the end none are perfect and all just an attempt at measuring severity.
if you have some ideas for improvement, let your state legislator know.