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  #1  
Old 11-03-2009, 03:45 PM
fifetow fifetow is offline
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Default What Does My QME Result Mean

Hi all. I am brand new to this so be kind (please?). I was injured a couple of years ago at work. After treatment for 3 years, I was determined to be stable. I had a QME 2 months ago and just got the results. I went to a number of websites to try to determine what they mean but just got more and more confused. I was rated an 8% WPI and then an additional (?)2% WPI for pain. Can anyone direct me to a place I can find out what this means (or give me a quick and dirty explanation)?

I am in the Sacramento area. I have continued to work at my place of employment with pretty strict accomodations. I have not hired an attorney-I dont want to rock the boat a lot because I have a very good job for a local city goverment and hoped to work there another 8 years until retiring (I have worked there 11 years at this point). However, I also dont want to get "hosed". I have pain every day and will likely the rest of my life. It ranges from a 2-3 for an average day up to an 7-8 for really really bad flare ups.

Any thoughts, suggestions, referrals to resources or explanations would be greatly appreciated. I cannot spend long hours on the computer, that is one of the activities that really flares my injury up so I cannot research it as well as I would like. I can spend about 30 minutes at a time at the computer and then have to walk or stand for an hour or two before more computer time....it sucks!
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  #2  
Old 11-03-2009, 03:58 PM
.SH .SH is offline
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Default Re: What Does My QME Result Mean

impairment ratings by a physician are used to calculate permanent disability benefits.
here is a factsheet on PD
http://www.dir.ca.gov/dwc/FactSheets/FactSheet_D.pdf

the state has a disability evaluation unit that performs the calculations
http://www.dir.ca.gov/dwc/DEU.html
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  #3  
Old 11-03-2009, 07:01 PM
raff03 raff03 is offline
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Default Re: What Does My QME Result Mean

Quote:
Quoting fifetow View Post
Hi all. I am brand new to this so be kind (please?). I was injured a couple of years ago at work. After treatment for 3 years, I was determined to be stable. I had a QME 2 months ago and just got the results. I went to a number of websites to try to determine what they mean but just got more and more confused. I was rated an 8% WPI and then an additional (?)2% WPI for pain. Can anyone direct me to a place I can find out what this means (or give me a quick and dirty explanation)?

I am in the Sacramento area. I have continued to work at my place of employment with pretty strict accomodations. I have not hired an attorney-I dont want to rock the boat a lot because I have a very good job for a local city goverment and hoped to work there another 8 years until retiring (I have worked there 11 years at this point). However, I also dont want to get "hosed". I have pain every day and will likely the rest of my life. It ranges from a 2-3 for an average day up to an 7-8 for really really bad flare ups.

Any thoughts, suggestions, referrals to resources or explanations would be greatly appreciated. I cannot spend long hours on the computer, that is one of the activities that really flares my injury up so I cannot research it as well as I would like. I can spend about 30 minutes at a time at the computer and then have to walk or stand for an hour or two before more computer time....it sucks!
I'm sorry for your injury, but I am also sorry that you will get hosed. I did not get an attorney because I felt like I didn't want to rock the boat either. Either way the boat will be rocked. Good luck
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  #4  
Old 11-03-2009, 07:06 PM
fifetow fifetow is offline
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Default Re: What Does My QME Result Mean

Thanks SH. I actually had already found those and read those two resources. I did truly research it quite a bit before posting my question. I had found those links on my own and then saw them in several other threads.The quick FAQ I get and I generally understand how the various settlements work (conceptually) and are made. What I cannot even begin to understand is.....what my particular ratings mean financially IE the info in the second link. I slogged through the very long schedule on calculations and it is obviously not intended for the average lay person. I am pretty fluent in goverment speakanese (and healthanese too) and this made me feel like I was reading Greek govermentanese! Can anyone direct me someplace (or explain to me in general overall terms) to a link that can explain what my rating translates to in laymens terms (roughly)? Is it normal to have two different ratings (one for pain)?

Thanks much.
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  #5  
Old 11-03-2009, 09:51 PM
fifetow fifetow is offline
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Default Re: What Does My QME Result Mean

One of the things really confusing me is some threads give a formula of 3 weeks x the percentage you are rated to equal your payment and other threads say it is 5 weeks....how can I tell where I would be. I am guessing my full rating is 10% (8% plus the 2% for pain)? My injury happened 3 years ago (May 2006). It was greatly exaserbated by my boss not complying with the recommendation of both my doc and our WC carrier to immed. give me an ergonomic desk (I had an old desk designed for about a 6'4 guy to sit at and meet with people-not at all designed for all day computer work for a 5'7 woman). It made me hold my arm up and didnt allow the injured nerves to rest and heal. My boss (unbeknown to our HR person) drug her feet and it took 2 years to get it. The doc said that delay likely turned this into a chronic injury when it otherwise would have likely healed completely after just a few months....really frustrates me. They could have spent 1200 on an ergonomic desk and now they will spend....?

Any help is appreciated. I have read until my back and brain are now throbbing but feel like for every one concept I grasp, there are 2 I do not!
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  #6  
Old 11-04-2009, 05:25 AM
BvIA BvIA is offline
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Location: Calif
Posts: 6,764
Default Re: What Does My QME Result Mean

Quote:
what my rating translates to in laymens terms (roughly)?
Looks like you are trying to find out how much money you are to receive...(?)
There is a labor code that provides the information you are seeking. Your 10% PD/WPI rating is scheduled for 4 weeks of each 1% of the rating... 40 weeks for yours.

Quote:
Column 2--Number of weeks
for which two-thirds of
Column 1--Range average weekly earnings
of percentage allowed for each 1 percent
of permanent of permanent disability
disability incurred: within percentage range:
0.25-9.75 ...................... 3
10-14.75 ....................... 4
15-24.75 ....................... 5
25-29.75 ....................... 6
30-49.75 ....................... 7
50-69.75 ....................... 8
70-99.75 ....................... 16
Take the 40week, x your PDA rate, which will probably be around $230/wk or so,(if you are a max wage earner) = $9200 indemnity due. As you are remaining in your pre injury job, you could be subject to the 15% adjustment to that PD amount.
Quote:
4658 (2) If, within 60 days of a disability becoming permanent and
stationary, an employer does not offer the injured employee regular
work, modified work, or alternative work, in the form and manner
prescribed by the administrative director, for a period of at least
12 months, each disability payment remaining to be paid to the
injured employee from the date of the end of the 60-day period shall
be paid in accordance with paragraph (1) and increased by 15 percent.
This paragraph shall not apply to an employer that employs fewer
than 50 employees.
(3) (A) If, within 60 days of a disability becoming permanent and
stationary, an employer offers the injured employee regular work,
modified work, or alternative work, in the form and manner prescribed
by the administrative director, for a period of at least 12 months,
and regardless of whether the injured employee accepts or rejects the
offer, each disability payment remaining to be paid to the injured
employee from the date the offer was made shall be paid in accordance
with paragraph (1) and decreased by 15 percent.
Meaning, if you stay where you are...your PD decreased by 15%. You would receive PD payments for 40 weeks totaling $7820 +/- based on the factors of your claim. You can petition for that to be commuted to a lump sum. You would receive that minus 3%/annum to bring the amount to ''todays dollars'' (about $7585.40). Medical treatment will remain available subject to prior authorization, and ACOEM/MTUS guidelines. As well as the UR process.
Quote:
It was greatly exaserbated by my boss not complying with the recommendation...
Probably no recovery there. Lots of IW are unsure about this issue. Restrictuons your PTP places on you, are on you, not your ER or the job you do. These restrictions pertain to your everyday activities. When your boss didn't provide the ''reasonable accommodation'', you should have 1) notified HR immediately, or 2) return to your PTP and tell him/her your ER could not accommodate your restrictions/light duty, and be returned to a TTD status until those (the desk) were provided.
Quote:
The doc said that delay likely turned this into a chronic injury when it otherwise would have likely healed completely after just a few months....really frustrates me. They could have spent 1200 on an ergonomic desk and now they will spend....?
In the end of any claim, it's about money. It's always about money, exposure to financial liability.
Unfortunately, as you/many IW's do not seek the advice of a I&A officer at the WCAB, or atty, there is no one to educate you on the process. If there were, you would have been advised to not work until the accommodation/desk was provided. Trying to 'think like' an IC... your frustration is well placed.... but let it go. The more you try to understand comp, the worse it will be. Just concentrate on a successful return to work, and no re-injury.
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  #7  
Old 11-04-2009, 11:06 AM
.SH .SH is offline
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Default Re: What Does My QME Result Mean

you are correct pd ratings are not for the layman. there are classes that you can take that can provide basic training in doing ratings; it is not something taught on a message board.
but perhaps you'll have more luck in using one of the internet PD calculators that are available .
here is a site by an applicant's atty that may get you what you want.
you have to register but the use of the calculator is free
http://www.pdrater.com/original-calculators/

Last edited by .SH; 11-04-2009 at 11:19 AM.
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  #8  
Old 11-04-2009, 02:16 PM
.SH .SH is offline
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Join Date: Oct 2006
Posts: 5,221
Default P.S.

it appears that you are confusing an impairment rating from a physician with a disability rating given by the DEU.
they are not the same.
the links should have explained the difference
your disability rating is NOT 8% + 2%
only the disability rating is converted into weeks.
try the calculator or wait until the DEU issues their calculation.
all finalizations have to be approved by the comp court to make sure there are no errors.
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  #9  
Old 11-04-2009, 07:47 PM
fifetow fifetow is offline
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Default Re: P.S.

Quote:
Quoting .SH View Post
it appears that you are confusing an impairment rating from a physician with a disability rating given by the DEU.
they are not the same.
the links should have explained the difference
your disability rating is NOT 8% + 2%
only the disability rating is converted into weeks.
try the calculator or wait until the DEU issues their calculation.
all finalizations have to be approved by the comp court to make sure there are no errors.
It is listed under the title Disability in the packet that was sent to me and he calls it perm. disability.....?
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  #10  
Old 11-05-2009, 05:45 AM
BvIA BvIA is offline
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Location: Calif
Posts: 6,764
Default Re: What Does My QME Result Mean

When your PTP submits a PR-5, or Physicans Report of P&S/.MMI it should contain a rating that is a final...PD/WPI. The DEU does not have to calculate a rating from your PTP final report, and your case can settle by Stipulation, or C&R with the rating from your PTP.

Unless there is a dispute to that rating, in that case, you would be evaluated by PQME or AME as the case requires.

Your PTP should have issued a rating that includes the impairment, and 2% for pain, even though it is referred to as an ''addon for pain''.
Quote:
all finalizations have to be approved by the comp court to make sure there are no errors.
All settlements are reviewed for adequacy to the IW... if there is agreement between the parties to the isuses in the claim... there can be settlement at any time.

Only if a party requests a DEU rating would there be a calculation, OR if the claim were set for trial. A judge will only accept a DEU rating. Even at that, the judge has the ability to add or reduce the final rating.
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