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  1. #1
    Join Date
    Apr 2009
    Posts
    3

    Question Body Impairment Ratings

    Is there a place which states the dollar amount per % of total body impairment for the state of Texas ? I have reached my MMI with a total of 10% for my body.
    I broke my ankle 6 months ago at work and just finished my treatments and was given a 7% for my lower extremities with a 3% for my total body for a combined total of 10 %.

    Any links or information would be greatly appreciated. I have seen links for other states but not Texas.

    Thanks

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Body Impairment Ratings

    Information on WC in TX is here...http://www.tdi.state.tx.us/wc/employ....html#employee

    I'm curious though how you equate a disability to the lower extermety...being a 'part of the body' with a % for whole person impairment... 7% to a 'body part', doesn't necessarily equate to 10% when you combine the whole body rating of 3%... your Whole Person Impairment should be the 3% (total person.)

    IIB/Impairment Income Benefits are
    Impairment Income Benefits (IIBs) [Sections 408.121 - 408.129, Rules 130.1 - 130.12]
    You may be entitled to Impairment Income Benefits (IIBs) if you have a permanent impairment from a work-related injury or illness. Generally, Maximum Medical Improvement (MMI) is reached when you are as well as you are going to be from the work-related injury or illness. This does not mean that you will not need to follow up care with your health care provider, be completely pain free, or that you are released to return to work. When the health care provider determines you have reached MMI, the health care provider will determine if there is any permanent physical damage. The health care provider will assign an impairment rating (IR) using the 4th Edition of the American Medical Associations (AMA) Guides to the Evaluation of Permanent Impairment. The impairment rating describes the degree of permanent damage to your body as a whole.

    If the injured employee has not previously reached maximum medical improvement, the workers' compensation law establishes MMI at 104 weeks. A doctor that is certified by the Division to do IR examinations must make an assessment of permanent impairment on whether the work-related injury or illness has been resolved or not. If an IR has not been assigned before the 104-week date when your temporary income benefits (TIBs) end, you may not receive IIBs until a doctor assigns an IR. TIBs can no longer be paid after 104 weeks (or maximum medical improvement). Your impairment rating determines whether you are eligible for IIBs. Three (3) weeks of IIBs are paid for each percentage of impairment.

    For example, if you receive a 10 percent IR, you will receive 30 weeks of IIBs because 3 weeks of IIBs are paid for each percentage of impairment (10 x 3 = 30 weeks of IIBs).

    Amount of Impairment Income Benefits

    Impairment Income Benefits equal 70 percent of your average weekly wage (AWW). There is a state maximum for impairment income benefits just as there is for TIBs. The maximum for IIBs is 70 percent of the state AWW.

    For example, if the state average weekly wage were $539, the maximum IIB rate would be $377.

    Average weekly wage $539
    70 percent of $539 = $377

    If your average weekly wage were $500, your IIB rate would be $350.

    Average weekly wage $500
    70 percent of $500 = $350

    If your average weekly wage is higher than the state average weekly wage ($539), such as $634.36, you will not receive 70 percent of $634.36, you will receive $377 per week, the maximum IIB rate allowed by law.

    Average weekly wage $634.36
    70 percent of $634.36 = $444.05 ($377 maximum limit for IIBs)
    http://www.tdi.state.tx.us/wc/employee/benefits.html

  3. #3
    Join Date
    Apr 2009
    Posts
    3

    Default Re: Body Impairment Ratings

    Quote Quoting BvIA View Post
    Information on WC in TX is here...http://www.tdi.state.tx.us/wc/employ....html#employee

    I'm curious though how you equate a disability to the lower extermety...being a 'part of the body' with a % for whole person impairment... 7% to a 'body part', doesn't necessarily equate to 10% when you combine the whole body rating of 3%... your Whole Person Impairment should be the 3% (total person.)

    IIB/Impairment Income Benefits are
    Thanks for your reply. I was read the doctors report by a office assistant that stated that 7% was related to the lower extremities and 3% was given to the whole body. From what I gather from you, using the maximum would calculate to 3 weeks times the 3 % times my weekly rate of $525. This hardly seems fair when my ankle (broken) still is bothersome/ painful after exercising and has been going on for 6 months.

    thanks

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Body Impairment Ratings

    Could be different... but the rating to the extremity is how the injury has cause impairment to your ankle..
    When that is converted, the 3%WPI, is how the disability to your ankle affects your 'whole person'

    This hardly seems fair when my ankle (broken) still is bothersome/ painful after exercising and has been going on for 6 months.
    No...it may not be 'fair'... but WC isn't.
    The intent of comp is to provide treatment to your injury, wage loss while you recover, rehabilitation if necessary, and wage differential, in states that provide for such...

    There is no compensation for what might be ''fair'' to the loss due to your injury... comp isn't like you would might receive in a personal injury case... there is no pain and suffering, or punitive damages for the injury you incured.

    You are supposed to recover (hopefully without restrictions) and return to your pre injury job/capacity and move on.

    The circumstance surrounding your injury, recovery, and RTW will determine the eventual outcome of the claim.

  5. #5
    Join Date
    May 2009
    Posts
    1

    Angry Re: Body Impairment Ratings

    Like others I have had the misfortune of meeting Dr Wright Wiley Singleton. Dr Singleton (place a blade in my back as for as being a paid Insurance Doctor). He gave me a 4% whole body before shoulder surgery and after surgery gave me the same 4% and didnt rate lower back and kneel at all. Medical record was given to him which his didnt consider. I dont know what the scalel should be for all injuries or one injury. PS MY question is has anyone filed a compalint against Dr Wright Wiley Singlton with Texas Medical Board or heard of him.

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

    Default Re: Body Impairment Ratings

    As a rule, IME reports must contain the EBM/Evidence Based Medicine the doctor is basing his opinion on.
    Including reference to your medical reports/test results, his physical evaluation...no matter how short it may be...and any authority of peer reviewed medicine being relyed upon.

    While this IME is just an 'opinion', and the IC places the most weight on this report, your treating physican can write a report to refute those findings/opinion, and its' all subject to litigation in a comp court.

    That is the difference between your personal health coverage and WC...there are disputes in comp that you don't have if you were paying the bills for treatment.

    ...(place a blade in my back as for as being a paid Insurance Doctor)....
    IME"s are paid by the IC's, and there is an OMFS/Official Medical Fee Schedule, the same as your treating physican... all of the medical treatment, and/or medical/legal costs are paid for by the ER/IC....Unless you seek a opinion/evaluation on your own, out of pocket, those are the opinions/reports your claim is based on.

    As I said above, there are disputed issues in most/all claims...and that is why there is a WC court...so a judge can attempt to decipher the medical evidence and make a decision/order.

  7. #7
    Join Date
    May 2009
    Posts
    2

    Default Re: Body Impairment Ratings

    I have had the fortune of having to see "Dr" Singleton about four (4) times. I was injuried 9 years ago and the last "exam" was three months ago and he took all of five (5) mins. to read my records and conduct the exam. The first three (3) exams were overturned, he set MMI at 4% total body (WC Dr. revised to 14%). He is a real "hero" for Liberty Ins.

  8. #8
    Join Date
    Jul 2007
    Posts
    64

    Default Re: Body Impairment Ratings

    Once you get your impairment rating. Take that and multiply it by 3. That will be how many weeks of benifits. Now take the amount of TIBS and multuply by .70. That will be the amount of the IIBS checks.

    Take Care

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