Texas Worker's Compensation - Help For Injured Texas Workers

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  1. #1
    Join Date
    Jun 2009
    Posts
    3

    Default Impairment Rating and MMI

    I am not sure what I need or should or should not do. My story is as follows:
    I injured my left wrist/hand/thumb in Nov 07. Went to Dr. (Care Now) weekly for 5 to 6 weeks. Had an MRI in Jan. '08 which only showed a ganglion cyst, rec'd a letter saying the cyst was not covered by W/C. Did 4 or 5 PT visits in Feb. (15 min sessions of 3 wrist exercises with 1lb weight, then 10 mins electric therapy? tingling sensation) Jun' 08 Went to some Dr. (PRIDE) in downtown Dallas for "evaluation with recommendations and interpretation of FCE"???? Have no idea what that means. Recommendations were made, have paperwork, but don't understand the medical terminology or what it all means for me.
    Last time I visited Care Now DR. was in March' 08. IC wants me to go to Care Now for an impairment rating. I keep seeing MMI on the forum, What is MMI???? What is an impairment rating?

    My wrist still hurts occasionally, Prior to injury I could do cartwheels, push-ups, play my flute, twirl my baton. Can't do any of that now with left wrist because it won't bend like it used too. I can't pick up anything over 10 lbs. My upper arm has lost muscle mass (bicep) due to wrist injury.

    I don't want money, I want the quality of life I had before injury. To be able to put some weight on my wrist, to play my flute, etc.! I was terminated from my employer in Nov. 08, I am fighting them now under unemployment benefits, they claim I quit / walked off job. I went home sick & called in the next day. Fire /terminated on the 3rd day.

    Do I need an attorney, is there a statute of limitations on my claim? I haven't seen a DR. since over a year because DR. never said I needed to schedule an appointment, employer made it difficult to leave work to go to DR.'s. and last time at Dr.'s he wanted to do an impairment rating. Asked him what that was, he didn't really explain clearly cause I still don't know what it is / it's purpose? / how does it effect me?

    I never missed a days work because of injury, just did my job as always with one hand. Employer had me sign a "Bonfide job offer" the first few weeks after injury, I refused to sign the second time because of the wording they used was untruthful. It said I was on light duty per doctor and was to be phone operator, greeter and customer service. But I never did those jobs, I did the same job i had done for 3 years prior to injury with no help, which wasn't easy with just one hand!

    I am concerned about Care Now Dr. he seems to act like it's all in my head and nothing is wrong with my wrist. That is why I have been reluctant to go back there. Both the PT Dr. and the PRIDE Dr. made recommendations, but Care Now Dr. seems to ignore their recommendations saying I don't need any other PT. IC had some Dr. review my file (meaning he read my case but never actually saw me) to which that Dr. said I should have been completely well after 6 weeks. I am like this guy has never seen me, how does he know anything????


    What to do, What to do???? Any advice or help would be greatly appreciated.

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

    Default Re: Impairment Rating MMI Help

    you may want to request a second medical opinion who can advise on possible treatment options.
    you need some basic information on how work comp works in texas.
    do you know if your employer had work comp insurance?
    https://txcomp.tdi.state.tx.us/TXCOM...earBackCache=Y

    go here for general information
    http://www.tdi.state.tx.us/wc/employee/index.html

    if the employer had comp insurance contact the carrier directly about getting a second opinon.

    if you need to talk to someone about pursuing additional benefits
    http://www.oiec.state.tx.us/

  3. #3
    Join Date
    Mar 2009
    Posts
    289

    Default Re: Impairment Rating MMI Help

    MMI is max. medical improvement. Impairment rating is a % of disability that you are given for your injury. If you haven't spoke to an attorney, it wouldn't hurt. They would be able to advise you. That's up to you, but that what I would do. Good luck

  4. #4
    Join Date
    Jun 2009
    Posts
    3

    Default Re: Impairment Rating MMI Help

    Yes, Wal-Mart has Texas Workman's Comp Insurance, it's handle through Arkansas Claims Management.

    I did speak to a local attorney the other day. He does not specialize in WC claims, he is a personal injury lawyer. Anyway, he wasn't of any help. Glad I didn't have to pay him a consultation fee. All he said was maybe I should get a second opinion and to do so it would come out of my own pocket. I can't afford to pay out of pocket being how I am currently unemployed and fighting Wal-Mart for unemployment insurance benefits. 3 kids and a mortgage, mom is the last on the list of needs.

    The Ark.claims (IC) lady wants me to get an impairment rating so she can close my case (her words not mine). If I go to get an impairment rating does that mean that's it? Case closed, done? So what happens 2 years from now and the pain is still there or gets worse? Case closed so nothing? I just have to suck it up and deal with it?

    Sorry if I seem short, not trying to be rude or anything, just really frustrated because I don't understand and I've tried reading the Tex. W/C Website, it might as well be written in some foreign language because I don't comprehend any of it. Would be nice if it was in layman terms.

    Last year I was sent some form from Texas W/C I think (It looked like a government form with the Texas seal/emblem on it). I filled it out and mailed it back to them. Haven't heard anything back about it, so I don't know what I filled out or why.

    Thanks for the help. Know where I can find a W/C Attorney in the far North Dallas area??? LOL

  5. #5
    Join Date
    Mar 2009
    Posts
    289

    Default Re: Impairment Rating MMI Help

    My advise is you should take the time to go see a good w/c attorney. You could possibly ask the attorney you spoke to the other day to direct you to someone or go to your state barr for one. Good Luck

  6. #6
    Join Date
    Jun 2009
    Posts
    11

    Default Re: Impairment Rating MMI Help

    Quote Quoting TexasGirl View Post
    Yes, Wal-Mart has Texas Workman's Comp Insurance, it's handle through Arkansas Claims Management.

    I did speak to a local attorney the other day. He does not specialize in WC claims, he is a personal injury lawyer. Anyway, he wasn't of any help. Glad I didn't have to pay him a consultation fee. All he said was maybe I should get a second opinion and to do so it would come out of my own pocket. I can't afford to pay out of pocket being how I am currently unemployed and fighting Wal-Mart for unemployment insurance benefits. 3 kids and a mortgage, mom is the last on the list of needs.

    The Ark.claims (IC) lady wants me to get an impairment rating so she can close my case (her words not mine). If I go to get an impairment rating does that mean that's it? Case closed, done? So what happens 2 years from now and the pain is still there or gets worse? Case closed so nothing? I just have to suck it up and deal with it?

    Sorry if I seem short, not trying to be rude or anything, just really frustrated because I don't understand and I've tried reading the Tex. W/C Website, it might as well be written in some foreign language because I don't comprehend any of it. Would be nice if it was in layman terms.

    Last year I was sent some form from Texas W/C I think (It looked like a government form with the Texas seal/emblem on it). I filled it out and mailed it back to them. Haven't heard anything back about it, so I don't know what I filled out or why.

    Thanks for the help. Know where I can find a W/C Attorney in the far North Dallas area??? LOL
    As I understand it, here's a breakdown of terminology in chronological order.

    First, you report the injury to the employer, who files a claim with WC. TDI, DWC stands for Texas Dept of Insurance, Dept of Workers Compensation.

    Then, you undergo treatment. When you reach MMI (maximum medical improvement) you receive an impairment rating. The dd (designated doctor-assigned by WC) assigns this rating, but you can appeal it.

    Financially, the first benefits are "wage benefits" and are figured using an average, and have a cap. I don't know what the cap is now, but it was $537/week when my dh was hurt 6 years ago and it didn't even touch what he would have made. Then, when an IR is assigned, if you have at least a 15%, you receive 3 weeks of pay for each percentage. For example, an IR of 25% would yield 75 weeks of pay, almost a year and a half. Then, after IIBS (impairment income benefits) end, you apply for SIBS (supplemental income benefits.) There are guidelines for SIBS which include an IR of over 15%, not taking IIBS in a lump sum, and being unable to work at the same capacity as previously able.

    Unfortunately, after 401 weeks, there is nothing. Nada.. Zip. Even if permanently and totally disabled. SIBS runs out. The system is broken, and is written exclusively for the employer.

    Add to that, TDI is it's own governing agency. All administrative claims go to them. All dispute resolution goes to them. All appeals go to them. There are no repercussions outside of WC. There's no one to sue. WC code is written such that *they* are the dispute resolution. It's bogus crap.

    Medically, the benefits are supposed to be long term. Some states offer settlements which alleviates the employer from responsibility, but TX does not. Definitely seek 2nd opinions and don't be afraid to find the MD on your own. Just be sure they take WC. We changed treating doctor once bc dh used to see three docs to do one job.

    Good luck!
    Blondie

  7. #7
    Join Date
    Aug 2009
    Posts
    8

    Default Re: Impairment Rating and MMI

    hey texas girl, I have the same problem as you. well, not all the drama with WC or my employer but i've hurt my left wrist at work and have little to no movement! I can use my fingers but they are slow and feel very tight.

    Im a groomer and a dog pulled me tearing my scapholunate liament in my left wrist. I was told it would heal within about 12 weeks. My injury was 11/21/08 and in may of 09 i was finally able to have surgery. now after 2 months (8 sessions) of PT i still am right back to where i started.. no movement. Im unsure about all the laws and everything, but I too am missing out on life. I have 2 little boys 5yrs and 2 years and am not able to pick them up, changing a diaper on my youngest is hard, taking showers, washing dishes.. etc. everything is difficult.

    Before the surgery i was given a hand out about MMI.. Im guessing they were going to release me and i would have gotten my assessment. but then WC stepped in and stated that i needed surgery. my doc wanted me to wait another 6 months (just incase it healed) which was BS! but he did it anyway., and here i am!

    What i was wondering is if you ever went and got your impairment testing done.. and what the rating was. I feel like i have lost out on a lot of things in life and there is a possibility that i will never be able to groom again (words out of my docs mouth!) and that scares me since i have been working for this company for 9 years. I have all the faith in my company and i dont think that they will ever fire me.. at least im hoping, but i have lost lots of money (we work off of commission) and lots of time with my kids. i cannot do all the things i used to, and i have missed out on all of it. Almost 1/2 of my youngest son's life i have been this way, and i cant even pick him up! its just heart breaking and i would like to be compensated for all the things that i cannot do. i know it sounds horrible, but this job is the only thing i know how to do and i dont know what else i could do other than stay home and be with my kids, and try to make up for all the lost time! and of course i cannot do that with only my husbands wages..

    if you know anything or found anything out, please let me know.

    thanks

  8. #8
    Join Date
    Jul 2008
    Location
    ca
    Posts
    863

    Default Re: Impairment Rating and MMI

    follow BeenTheres advice. Get a work comp attorney. The consulations wont cost you anything. I talked to several before I signed. Be honest and tell them you are talking to a few and go with whom you think will be best for you.

    I also agree that the PI could of referred you to a wc attorney. Do your research before you sign....

    Good luck
    Never doubt that a small group of thoughtful, committed citizens can change the world...indeed...its the only thing that ever has - Author Margaret Mead

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