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Will I get an impairment rating on multiple levels of my spine at MMI examination?
#1
Question 
***TEXAS***
I had multiple procedures done on my spine due to a semi to semi collision that took place while at work. According to the AMA Guides, the minimum impairment rating for spine levels is 10% if surgery was performed. However, I am confused as to how many levels I will be compensated/evaluated for.

Here is what I had done:
(L4-L5 Fusion, Laminectomy, and Foraminotomy) and ( L4 Foraminotomy ***Decompression/Bone removal***)
 
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#2
I don't have access to the the 4th edition of the AMA guides.
check with your doctor or a library (generally at a local medical school).
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
p.s.
here is some help from the 5 edition (which is not used by texas but may not be that much different)
http://www.neurosurgical.com/insurance/a..._spine.htm
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#4
(03-12-2018, 12:50 PM)Kappa6m3 Wrote: ***TEXAS***
I had multiple procedures done on my spine due to a semi to semi collision that took place while at work. According to the AMA Guides, the minimum impairment rating for spine levels is 10% if surgery was performed. However, I am confused as to how many levels I will be compensated/evaluated for.

Here is what I had done:
(L4-L5 Fusion, Laminectomy, and Foraminotomy) and ( L4 Foraminotomy ***Decompression/Bone removal***)

All IR's in Texas are converted to a "whole person" IR. Therefore the physician will rate according to the 4th Edition third printing or later. In Texas the DWC regards the spine as one body area. However this does not mean that the examiner will rate the three areas of your spine as one area.

The ratings are combined, not added. If the highest rating of any one part of your body is 10% then the next area is rated based on 90% functionality and so on until each area is rated and combined. In all cases the ratings are then converted to "whole person".

In the end the spine rating may be 27% or 26% where you had 10% of cervical, 10% of thoracic and 10% lumbar. There are some technical issues as to whether you are rated using "range of motion" or "diagnosis related estimates" when you have your spine rated for permanent impairment.

I would also note that the statutory MMI date may be increased beyond 104 weeks due to spinal surgery BUT you must apply for the extension before a certain time passes.

Compensation for permanent impairment is not the same as temporary income benefits, supplemental income benefits or lifetime income benefits.

Please see Title 28 Texas Administrative Code Part 2 chapter 130 for IIB's.

Permanent impairment is rated and then by law the carrier pays you 3 weeks of income for every 1% of impairment. The payment is based on a percentage of your average weekly wage. (70%) and is maxed at $570.00/wk or so at this time.

If you receive 14% the payment should be around $7980 roughly if you get the maximum IIB.

You will qualify for supplemental benefits if your IR is 15% or above.

Remember this is STRICTLY for your impairment. Not related to income benefits or supplemental income benefits Please read the rules I quoted above.

Brian
Workers' Compensation JOAT
Texas Independent Evaluators
817-500-5770
 
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