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  1. #1
    Join Date
    Dec 2007
    Posts
    91

    Default Question On Rating Impairment To Lumbar Spine

    what is involved in rating the lumbar spine?

    the hearing rep told me that the most I could get is an 8%-10%,I told the hearing rep that the PTP told me that he (the PTP) is thinking the I might be getting a 35%-40% Impairment rating. The hearing rep told me the the PTP was out of his mind, he went on to say that I would only get 8%-10% no more, now if you want a higher rating, we can now go for the amended body parts.

  2. #2
    Join Date
    Feb 2007
    Posts
    550

    Default Re: Question On Rating Impairment To Lumbar Spine

    I think the Hearing Rep is correct and the dr is:

    1) Smoking crack (pharmaceutical grade stuff) or
    2) Using the OLDER Perm Disability Rating Schedule.

    You were found to be P&S (MMI) after 1-1-05, so you will be under the new schedule, and then WPI (Whole Person impairment) is used. And, YOU DID NOT HAVE SURGERY did you? With a basic lumbar issue, no surgery, no paralysis, wheelchair, or drooling the ratings are abhorrently low!!! Sorry.....

    Do you have a rating from the DEU? Ask the Rep to see a rating from ANYBODY....


    LA

  3. #3
    Join Date
    Dec 2007
    Posts
    91

    Default Re: Question On Rating Impairment To Lumbar Spine

    Quote Quoting princessLA View Post
    I think the Hearing Rep is correct and the dr is:

    1) Smoking crack (pharmaceutical grade stuff) or
    2) Using the OLDER Perm Disability Rating Schedule.

    You were found to be P&S (MMI) after 1-1-05, so you will be under the new schedule, and then WPI (Whole Person impairment) is used. And, YOU DID NOT HAVE SURGERY did you? With a basic lumbar issue, no surgery, no paralysis, wheelchair, or drooling the ratings are abhorrently low!!! Sorry.....

    Do you have a rating from the DEU? Ask the Rep to see a rating from ANYBODY....


    LA

    I do not have a rating as of yet, not from the Dr final report nor from the DEU.
    form what the hearing rep said about the rating being 8%-10% would that include (FEC) occupation and age in the rating?

    the hearing rep also siad that with (stips award) would go into a escrow acount for future medical and that the I/C would never C/R, is that true?

  4. #4
    Join Date
    Jun 2007
    Posts
    344

    Default Re: Question On Rating Impairment To Lumbar Spine

    I can tell you from experience that PLA is pretty much right on. Under the old rating schedule 35-40 would probably be very real. Today things are much different. You might get a point or 2 more but it ain't much.

    In reading your other posts it you stated something about a hardship. Makes me wonder if maybe you are pushing to be made P&S so that you can go back to work. . I can certainly understand this. What I would be concerned with is whether you would be jeopardizing your health. I don't know all the details but would really hope you think this through very carefully.

  5. #5
    Join Date
    Dec 2007
    Posts
    91

    Default Re: Question On Rating Impairment To Lumbar Spine

    I have had 4 injurys that I reported to the employer and had the injurys check by the company doctors prior to the 7/05 injury(lower and upper back) and never went off work for those injurys, the manager allways found a way to talk me out of it. the I/C is not fighting the claim just payment.

    the hardship is do to no income. the hearing rep never informed me of SSDI or SDI. I went to the hearing reps office today, I informed him that I was going to apply for SSDI or SDI and the hearing rep just looked at me with a plain poker face and said nothing.

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Question On Rating Impairment To Lumbar Spine

    I have had 4 injurys that I reported to the employer and had the injurys check by the company doctors prior to the 7/05 injury(lower and upper back) and never went off work for those injurys, the manager allways found a way to talk me out of it. the I/C is not fighting the claim just payment.

    Were there WC benefits paid on those injuries? An actual claim filed with the IC...and was there ever an actual rating done on this...?
    IF there was, there will be apportionment to your injury this time...that means that your rating can/will be reduced by the amount of your previous injury/PD...

    the hardship is do to no income. the hearing rep never informed me of SSDI or SDI. I went to the hearing reps office today, I informed him that I was going to apply for SSDI or SDI and the hearing rep just looked at me with a plain poker face and said nothing.

    If you filed for SDI/UE benefits at the time of your DOI, you may be eligible for those benefits after you are declared P&S/MMI, or if your TTD runs out before that time, and your doctor says you still cannot return to your job.
    You should have done this in order to protect your date of entitlement to the benefits.

    As to SSDI...based on your information/posts to date...do not bother with applying for SSDI/SSA benefits...you will not qualify with a 'soft tissue', bulging disks injury...you must be UNABLE to perform ANY kind of gainful employment for a period of not less an 12 months, or your condition end in death...the threashold for SSDI is much higher vs WC.

    To get your PD indemnity commuted at the time of your Stips, or any other time there are specific terms to be met...

    The Labor Code provides for commutations of your PD..

    5100. At the time of making its award, or at any time thereafter,
    the appeals board, on its own motion either upon notice, or upon
    application of either party with due notice to the other, may commute
    the compensation payable under this division to a lump sum and order
    it to be paid forthwith or at some future time if any of the
    following conditions appear:
    (a) That such commutation is necessary for the protection of the
    person entitled thereto, or for the best interest of the applicant.
    In determining what is in the best interest of the applicant, the
    appeals board shall consider the general financial condition of the
    applicant, including but not limited to, the applicant's ability to
    live without periodic indemnity payments and to discharge debts
    incurred prior to the date of injury.
    (b) That commutation will avoid inequity and will not cause undue
    expense or hardship to the applicant.
    (c) That the employer has sold or otherwise disposed of the
    greater part of his assets or is about to do so.
    (d) That the employer is not a resident of this state.

    http://www.leginfo.ca.gov/cgi-bin/di...file=5100-5106


    the hearing rep also siad that with (stips award) would go into a escrow acount for future medical and that the I/C would never C/R, is that true?

    You must have mis-understood something along the line...
    IF you settle this by Stipulation/Award, or Finding/Award, you will be paid the PD/WPI indemnity (the award) in bi-weekly payments until the award is exhausted...minus the atty fees.
    The future medical will remain open...for life.
    There is no ''escrow'' account..

  7. #7
    Join Date
    Dec 2007
    Posts
    91

    Default Re: Question On Rating Impairment To Lumbar Spine

    Were there WC benefits paid on those injuries? An actual claim filed with the IC...and was there ever an actual rating done on this...?
    IF there was, there will be apportionment to your injury this time...that means that your rating can/will be reduced by the amount of your previous injury/PD...

    I was never payed for the other injurys that I sustained while being employed 17 years at the same company. the only benefits paid were the doctors visit and was never found to PD until now

    Now as for SSDI it would not be just a soft tissue claim , PER AME : DIAGNOSES:1. LUMBAR DISC HERNIATION, L5-S1 WITH PARTIAL TEAR.
    2. COINCIDENTAL SPONDYLOLYSIS [PARS DEFECT]L5.

    APPORTIONMENT( PER LABOR CODES 4663/4664 AND ESCOBEDO DECISION)
    NOW I DON'T THINK THE SPONDYLOLYSIS, IN AND BY ITSELF, IS CAUSING ANYTHING, IT IS SIMLY THERE. THE PROBLEM, OF COURSE, IS THAT THERE IS A DISC HERNIATION AT THAT LEVEL AND WE NEED TO SOMETHING SURGICALLY, THEN THE LOOSE LAMINA, WHICH IS A CONSEQUENCE OF THE SPONDYLOLYSIS, NEEDS TO BE TAKEN CARE OF. IN OTHER WORDS, I DO NOT FEEL THERE IS A BASIS FOR APPORTIONMENT TO SOMETHING CONENITAL OR PRE-EXISTENT.

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
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    Default Re: Question On Rating Impairment To Lumbar Spine

    ''I was never payed for the other injurys that I sustained while being employed 17 years at the same company. the only benefits paid were the doctors visit and was never found to PD until now''

    Per AME report...''APPORTIONMENT( PER LABOR CODES 4663/4664 AND ESCOBEDO DECISION)
    NOW I DON'T THINK THE SPONDYLOLYSIS, IN AND BY ITSELF, IS CAUSING ANYTHING, IT IS SIMLY THERE. THE PROBLEM, OF COURSE, IS THAT THERE IS A DISC HERNIATION AT THAT LEVEL AND WE NEED TO SOMETHING SURGICALLY, THEN THE LOOSE LAMINA, WHICH IS A CONSEQUENCE OF THE SPONDYLOLYSIS, NEEDS TO BE TAKEN CARE OF. IN OTHER WORDS, I DO NOT FEEL THERE IS A BASIS FOR APPORTIONMENT TO SOMETHING CONENITAL OR PRE-EXISTENT. ''

    That's fine, and may handle the issue of apportionment. Why did you not have the surgery the AME recommended? (that may have contributed to your final WPI rating, as well as helped with your pain issues)

    Regardless...what your diagnosis/prognosis will in all liklyhood not produce the results you seek in applying for SSDI benefits...I believe you will be denied benefits, as you are able to perfor some kind of 'gainful employment'...(which means basically that you are capable of earning about $900/month.)

    the hearing rep just looked at me with a plain poker face and said nothing.

    That basically means..."And...(?)"....

    What is it you are looking for?...higher rating (which will bring more restrictions and make it more difficult to find another job)...More money?...no one ever "retires" from a WC claim...the 'awards' are pretty much set by law, and don't amount to much anymore...sadly.
    Do you feel that you are not ready, ..physically, to RTW...?

    What are the 'amended body parts' you mentioned adding to your claim?
    Fill us in on what the 'issues' are you are having difficulty with....(?), please.


    ''form what the hearing rep said about the rating being 8%-10% would that include (FEC) occupation and age in the rating?''

    Yes, a final WPI rating takes all that into consideration.
    There are cases working their way through the courts on disputing the value of the PD indemnity, though expert testimony at trial...by Vocational Rehabilitation professionals...Charles has more information on this.

  9. #9
    Join Date
    Dec 2007
    Posts
    91

    Default Re: Question On Rating Impairment To Lumbar Spine

    If You Want To Know Why I Did Not Go On With Surgery, You Need To Go Back To My Other Posts That You Had Already Posted To. If I Go On With Surgery I Will End Up On Skid Row. I Have To Return To Work With All My Restrictions, The Dr. Released Me On 11/07 And No Pd Rating As Of Yet. no Income, No Family

  10. #10
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Question On Rating Impairment To Lumbar Spine

    I can understand yoiur frustration...
    But, I'm not going back and re read your 'life story' of posts...
    If you want to ask questions, and continue, stay on on post/thread and continue to get the assistance you desire..
    But jumping around, posting multiple time on different topics make it difficult to follow your 'story'....and it's very easy to lose interest when it's difficult to keep tract in multiple posts...
    Which to tell you the truth...I have here.
    Further more, like on other posts, it's like pulling teeth to get information from you on what is going on in your circumstance...and getting accurate infromation from you to offer substantive help where you seem to need it most.

    I'm sorry for your frustration...but believe me when I say, You are not unique...and regardless of your wishes, it appears you have exhausted your benefits entitlement...under the laws as they are today. Your best option to help yourself and your family is to return to gainful employment as soon as possible...

    Good luck to you, and Happy Holidays to you and your family.

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