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  1. #1
    Join Date
    Nov 2008
    Posts
    32

    Default Confused Over Impairment Rating

    My husband went for his physical impairment rating this week with the doctor who has been his primary physician through all this. His original diagnosis on my husband's back/leg/spine issues were L4/L5 radiculopathy with lumbosacral plexopathy plus the issues of his brain damage (that will be rated by a different physician).
    The doctor spent about 5 minutes talking to him about his pain levels (continuous 6-7 with some bad days of 9), reaffirmed the fact that there's no surgery to fix the damaged nerves only time, asked if he was still having numbness in his legs & were they still giving out when he walks (yes to both).
    He checked the reflexes in his knees and kind of poked on his back to see how tender it was...it was bad enough hubby about went down to the ground. And that was it, end of exam.
    Today we were told by his office that his rating was 12%, permanent restrictions are no lifting over 10 pounds, no bending or twisting, no standing or sitting for prolonged periods of time.
    This rating seems awfully low to us given the nerve damage & loss of movement and it seems like the exam should have been more thorough? I know the doctor did not want to do the rating & it took WC a while to get him to agree to do it...I'm wondering if maybe he just doesn't know how to? I've called our attorney to ask her if we need to get an IME set up, waiting for a call back. Just wondered what other's thoughts were on this.
    Thanks-
    Last edited by kycountrymom; 04-23-2009 at 10:16 AM. Reason: Added info

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Confused Over Impairment Rating

    you can get another rating but it doesn't make this one go away. the result will have to be negotiated e.g. if another says 20% then he might get 15 or 16.

    make sure the monetary difference is worth the delays.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Confused Over Impairment Rating

    PPI Examinations by Employer’s Physician; Second Opinions

    An injured employee’s PPI is most often assessed by the treating physician. Physicians use the American Medical Association’s Guides to the Evaluation of Permanent Impairment in evaluating the employee’s impairment rating. A PPI rating is stated by the doctor in terms of a percentage of loss or loss of use of a body part or the whole body, for example “The employee has suffered a loss of 10% to the hand,” or “The employee’s impairment is 25% to the whole body.”
    The rating you received should indicate if it is for 'body part', or 'whole person'..if it's WPI/Whole Person Impairment, that is how the % disability relates to the person as a whole and ability to compete in the open labor market. eg you could have a PD % to a body part of 50%, but when converted to WPI it may only be 15%.

    PPD indemnity is paid based on 'degrees' and the % rating. There are max rates of compensation too... for the 12% rating/degrees the indemnity is $1500/per degree...$18000.00, but there could be other factors as well. Could be more based on the DOI/date of injury.

    There is information on PPD and ratings here...http://www.in.gov/wcb/handbook/HANDB...nforImpairment

    The full handbook is here...http://www.in.gov/wcb/handbook/HANDBK2007.htm, and will help with most of your questions.

  4. #4
    Join Date
    Nov 2008
    Posts
    32

    Default Re: Confused Over Impairment Rating

    Thanks for the comments. We had just thought that the dr (who is his pain management doc) would actually do an exam- you know, measure how far he can bend, that sort of thing. Instead all he did was what he's done at every single appointment, the checking knee reflexes & poking on his back. I guess we thought the rating would be higher because this doctor along with all the others have repeatedly told him he'll never be able to work again because of his injuries & limitations.
    I'm just getting frustrated & the fact that our attorney hasn't gotten back to me isn't helping. I wanted to know if we needed to schedule an IME or if they thought hub's work restrictions would play a part.
    And I have concerns about the doctor doing his cognitive rating, he's another pain management doctor. I'd have thought it would need to be done by a neuropsych or someone along those lines. The first meeting with him didn't go well...he flat told hubby that in his expert (?) opinion & after speaking to him for 15 minutes all the brain damage would be gone in 4-5 months. Guess the docs who told us it was permanent were quacks. <eyeroll> The only good thing he did was recommend an MRI of his head/brain which we've been requesting since day 1, all the others done have been from the neck down. So I guess we'll see if the IC approves that or not.
    Thanks for letting me vent, my son's getting tired of being my only outlet & my husband just doesn't quite comprehend what's going on.

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