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  1. #1
    Join Date
    May 2010
    Posts
    7

    Default 30% Impairment Rating of Shoulder, Want to Take New Job

    I recently have recieved a 30% impairment rating of my shoulder by my ptp and it appears that the IC will not dispute the report which would be excellent news I have been offered a job doing the equivalent of desk work in relation to my previous job which was very physically demanding and became impossible for me.
    I need health insurance for my family and need to take this job. Will the IC use it as a reason not to pay me the PPD which they indicted today would be processed and sent next week. I guess I am entitled to a certain amount based on the date when they last paid me benefits??
    I just want this to be over soon and get on with my life and go back to some kind of productive work
    I also saw a link some months back that told you approx what you should receive based on your rating does anyone have that
    They may also settle future medical which I have been advised against. What kind of projection would I expect if my reports covers future shoulder arthroplasty. I found the tables based hcpc codes and boy do they low ball fees. To those of you who answer the posts your generosity of time is evident and greatly appreciated if not obvious in my prior post Thanks

  2. #2
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: 30% Impairment Rating of Shoulder Want to Take New Job

    as long as the job is within your permanent restrictions your benefits are not in jeopardy.
    partial disability means you are expected to work in a less demanding job.
    benefits are state specific; there is not a universal payment system.
    each state has it's own medical fee schedule.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: 30% Impairment Rating of Shoulder Want to Take New Job

    I found the tables based hcpc codes and boy do they low ball fees.
    Those fees are the amounts providers are paid to treat your work injury...no low balling...the OMFS/Official Medical Fee Schedule in Calif for example reflects approx Medicare fees plus 20%.
    The OMFS is currently being discussed by "interested parties", including the DWC Medical Unit, and providers across the state in revising the fee schedule. Naturally that would be downward.

    If you close the medical in a comp claim, you are agreeing to assume liability for your injury out of pocket. We/IW's are not afforded the luxury of contracted fees, ie Blue Cross/Anthem, or Medicare fees, or the OMFS of the comp system. We would be charged the 'usual and customary' fees providers normally bill.

    As you are in Calif, the Disability Payments link you are looking for is here http://www.leginfo.ca.gov/cgi-bin/di...file=4650-4664
    Your 30%PD/WPI is paid at 7wks for each 1%, or 210 weeks. If you take the PDA rate of $230 X 210wks, your indemnity is approx $48,300+/-.
    If you return to work with your pre injury ER, or that ER makes a job offer, the indemnity will be reduced by 15%, depending on the facts surrounding your claim. Those rules too are contained in the above link. Section 4658(2)

  4. #4
    Join Date
    May 2010
    Posts
    7

    Default Re: 30% Impairment Rating of Shoulder Want to Take New Job

    thank you for that insight and yes closing the medical is not in the interest of the IW.
    As for the doctors report he placed my shoulder at an impairment rating of 30% which I thought would be calculated down to a percent disability of approx 24% according to a prior link that gave these very convoluted equations
    This would have put the PD at about approx 20,000 although I really like the prior figure you gave Biva, one could only hope
    Thanks again

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: 30% Impairment Rating of Shoulder Want to Take New Job

    A final report from PTP or AME'/QME should be ratable, and contain a final PD/WPI rating.
    If you or the CA dispute the rating, you can request one from the DEU/disability evaluation unit. All PQME reports are automatically submitted to DEU. (or at least are supposed to be)
    As for the doctors report he placed my shoulder at an impairment rating of 30%
    If that 30% is shoulder only, it's not a final rating. You must be rate for WPI/Whole Person Impairment. Not just the body part injured. That 30% could be reduced significantly... much lower than 24% even. Possibly closer to 5% or 7% even.

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