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Need information on impairment ratings, not sure what to do!
#1
Question 
Hi,

I'm new to the forums. I live in WA and am coming close to L&I closing my case. I injured my Left knee breaking up a fight in a bar I was tending in July 2008. I had knee surgery on it in April 2009, which actually made it worse! It was a lateral meniscectomy and debridement for loose cartilage. I have had severe pain in it since the surgery, popping, grinding, instability and locking. I have gone to PT since April, and have just recently changed doctors to a family physician to manage my pain since the ortho surgeon said there wasn't much more he could do medically. Both ortho and PT blames the pain and instability on the chondramalacia.

My case manager sent me to an IME ortho surgeon, Dr. Green, who sent me for an MRI. I talked to my case manager and had her read me the report since I just want to know what he found. There is narrowing of something, sorry not sure what she said, laxity, and signs of the chondramalacia. He rated me an impairment of 9%. What does that mean for me? I am still on pain medication and have moderate pain even while on it. I live in a California split house with a lot of stairs, work for 2 elementary schools 1-1 with 2 autistic boys (7 and 9 yo) and have 5 kids of my own!!! My case manager says that she believes I have reached MMI, but my PT thinks that a lateral release might help me. I go to see my general practitioner on Monday, who I will ask all these questions, too.

Any advice is much appreciated! I am only 34 and my knee doesn't allow me to do near as much as I used to! I used to ref all my kids' soccer games, but now can't even give them an under dog on the swings! Sad
 
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#2
Hi Sha, and Welcome to the Forums!! I'm not too Familiar to the Laws in Your State, but if You are getting close to the End of Your Case, and You Feel You need More Medical Care, You may want to Ask for a Second Opinion, or Hire and Attorney that Works in the w/c Arena to represent You so that All goes Well. From what You have Written, You don't Sound anywhere Near Healed, or Satisfied with Your Knee's Healing, and You need More Care. Hopefully Someone from Your State will be On, Sometimes it's a bit Slow on the Weekends, so Hang in There, and Check Your Thread for Other Answers!! My Best to You!Wink
 
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#3
I have been thinking about getting a lawyer, but not sure if I want to go that route since then I would have them to payout at the end. I'm not sure what 9% gets me, but I feel it probably won't pay for my appointments and medication for very long as it is. Sad Even my first ortho, who only spent 3 minutes with me each visit, told me I was probably looking at another knee surgery down the line.

I haven't asked L&I for anything except my medical bills paid and prescriptions. I guess this is what frustrates me! I even scheduled my knee surgery during spring break so I would only be off work 1 week and not 2.

When I spoke to my case manager last, she told me that I already had a second opinion done. She is referring to the IME they sent me to who did the rating. My general practitioner said she still has to sign off on what ever Dr. Green says, so I will see on Monday what she thinks.

Thanks for the advice!

Sha
 
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#4
permanent disability payments are not medical benefits. Medical benefits will continue in addition to your rating.
Have you read any of the on-line information explaining washington's work comp system?
if not you can start here
http://www.lni.wa.gov/ClaimsIns/Claims/B...efault.asp
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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#5
1171 Wrote:permanent disability payments are not medical benefits. Medical benefits will continue in addition to your rating.
Have you read any of the on-line information explaining washington's work comp system?
if not you can start here
http://www.lni.wa.gov/ClaimsIns/Claims/B...efault.asp

Thanks for the site! I really don't know even what questions I should ask my doc on Monday. If anyone can think of some I should ask, please post them. Wink

I was under the impression that if my doc signs off and agrees with the IME's findings, my case would be closed and the settlement from the rating would be there to pay for my appointments for my chronic pain. At least this is what the case manager was telling me. It doesn't seem fair though! If I am still having to go see a doc and be on meds for pain, how can they say that the money I receive is to cover any further appointments. It wouldn't cover it for very long, would it? She said it was because I am at MMI!! I would trade any money for them to be able to get me back to my previous function, or at the very least, continue to pay for my appointments and medications! The way my PT explained the chrondamalacia is the bone on bone pain. I will always have to deal with that, and then more than likely arthritis. Sad I am not very old, so that doesn't leave me a lot of hope.

Thanks again!
 
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#6
not all treatments after you are at MMI are covered
again
this information is covered in the link I gave you:
"What medical care is not covered by workers' compensation?
Workers compensation cannot pay for:
Medical conditions not related to your workplace injury.
Treatments with benefits that cannot be measured objectively by a doctor or that continue after the worker is medically stable.
Treatments not covered by workers comp, such as acupuncture."


talk to your doctor about what treatments will be covered and which won't after you are declared MMI.
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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#7
I am from WA state and I advise you to hire a lawyer as soon as possible.
This state is one of the worst trying to kick you out from the system without a fair settlement or medical treatment.
I was injured in 2004, still fighting the system as of today. I didn't have a lawyer in the first two years and that was the biggest mistake I ever made.
To consult a lawyer cost you nothing and since you already have that 9% rating, that's yours to keep, you don't have to share that with anyone. I think that rating was done too early as you say you are still in pain and probably need more surgery in the future.
Good luck.
Kat
 
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#8
Welcome to the forum!

I agree with Kat it is time to hire an attorney.

Mine was bilateral knee injury/2005. I did not hire an attorney right away, had surgery 5 months after the injury was placed at MMI a few months later and my medical was closed.

Problem was when I was placed at MMI (closing of my case) I was given no work restrictions yet had limited mobility due to the instability of the knee.

I hired an attorney and had my medical reopened.

Since I've had 2 more knee surgeries and will have another in the near future.

If you go this alone without an attorney you medical will be closed and health insurance will not pay for medical for you knee due to it being a work injury.
 
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