Dental Injury at Work

**Wagonburner** · 08-25-2009, 01:08 AM

Need a little help if anyone can give advice. To get started i was approx 10' on a ladder drilling a 1/2 hole in the concrete floor above my head with a heavy duty hilti hammer drill, when the bit caught a piece of re-bar. Slapped me like a red headed step child and loosen 7 of my front teeth. Yes i also hit the floor from that height. Question is that Wyoming's workers comp cannot find anyone in the state of South Carolina to do a impairment rating. They actually did the impairment rating without asking me any questions about if i had any problems with eating,talking,how my face looks when i don't have my DENTURES!!! in. Yes Dentures. They had decided that i had bone lost around my teeth, the only thing that i had was my gums around my teeth!!. But they decided that pulling all " 28 " of my teeth instead of implants was going to be the only thing that they would be able to do. So here i am with No teeth and No damn choice. So I have a very hard time eating about anything. To embarrassed to even think about getting caught with them In my mouth around my girlfriend. And when iam home alone i take them out because they hurt so damn much and I get a phone call everybody on the other end thinks that iam drunk because i cant even talk!!!. So They had the impairment rating without asking me any thing and a Dr. in Casper WY. did the rating review and i look beside her name and it saids ( Practice Limited to Rheumatology only ). Iam I crazy or is that ( Arthritis ). But never the less I get a letter in the mail today Stating that the impairment rating is Zero!!!. Has anyone here had any of the same injury and can kind of let me know where the are going with this. Because I have very big issues with this. Hell iam mad cause i cant taste my food anymore!!

Sigh: Tasteless in South Carolina

**BvIA** · 08-25-2009, 06:41 AM

Where is your claim...? Wyoming, or South Carolina... it makes a difference as the laws are state specific... which state laws are you complying with...?

**Wagonburner** · 08-25-2009, 11:08 AM

with Wyomings

**BvIA** · 08-25-2009, 12:25 PM

Information on WY PPD ratings, and benefits is here http://wydoe.state.wy.us/search.asp?...submit1=Search

This info will help guide you in the process...What You Need to Know Regarding Your Claim
http://wydoe.state.wy.us/doe.asp?ID=78

Generally, once you reach a stable condition...MMI, your treating physican will evaluate you and rate to Permenant Partial Disability. [QUOTE]

Permanent Partial Impairment Benefit (PPI)

(a) You may qualify for this benefit if, as a result of your work-related injury or condition, you have sustained permanent physical impairment (PPI). A qualified health care provider will determine the percentage of impairment attributed to your work-related injury. This impairment may also be referred to as ascertainable loss.

(b) All physical impairments are measured according to the most recent edition of Guides to the Evaluation of Permanent Impairment by the American Medical Association.

(c) When an impairment rating is received by the Division, an award will be calculated and the Division will notify you of the value. You will be given the opportunity to either accept or object to this award. You must notify the Division of your decision. If you agree with the impairment rating, you must submit an application for a PPI award. The PPI benefits are paid monthly and cannot be disbursed in a lump sum.

(d) A Final Determination for PPI benefits will be issued. If you disagree with the determination, you must submit, in writing, an objection and request a hearing before the deadline given on the letter of determination.

(e) If you or your employer dispute the physical impairment, a second opinion will be obtained and the Division will consider both ratings. The second opinion will be scheduled by the Division. Prior awards and pre-existing conditions may reduce the amount of this benefit.[/QUOTE]

As ratings are subject to dispute, and litigation, it would stand to reason that a physican licensed in WY be the one to rate you for PPD.
That would require you to travel, at the ER/IC expense back to WY for that evaluation.

Keep in mind, IF there is a dispute to that rating, the ER/IC is not usually liable for the costs associated with litigation/hearings. Those travel expenses would be out of your pocket.

Medical evaluaitons/exams are the ER/IC costs.

The division could appt an attorney for you if necessary...

Attorneys and Fees

In a contested case hearing, the hearing officer may appoint an attorney to represent you. Once you are legally represented, communication with the Division should be through your attorney. The hearing officer may allow an appointed attorney reasonable fees for service at the conclusion of the proceedings.

According to the Workers’ Compensation Act, any person(s) who knowingly makes or allows any misrepresentation or false statements to be made for the purpose of receiving payments under the Act is guilty of a misdemeanor or felony under Wyoming law.http://wydoe.state.wy.us/doe.asp?ID=101

But never the less I get a letter in the mail today Stating that the impairment rating is Zero!!!.

Ok, read through the links above, watch the timeframes, you must make your dispute known in writing within the time allowed or you could lose valuable rights/benefits

If it was not a doctor in WY, you should dispute the zero rating...it doesn't make sense that a doctor outside the specialty of your injury, or out of state would issue a valid rating to your PPD.

You can also request help here

E-mail AskMeWC@state.wy.us with questions or comments
regarding the information on this page.

**Wagonburner** · 08-26-2009, 03:43 AM

It was a Wyoming Dr, That beside her name and address states that her practice is limited to (Rheumatology). Which I feel that she should have contacted me and ask me any and all questions about this case. Only if she was qualifly to do so. If she wasnt, I think that W/C should have the impairment rating done by a qualifly Dr that specailizes in this. I guess that iam going to have to get a Attorney to resolve this matter. Because it still hurts to eat. And this is a real pain even dealing with these plastic teeth!!

**BvIA** · 08-26-2009, 07:15 AM

Your frustration is understandable. And you have a right to see a doctor in the specialty of your injury/loss to perform the evaluation and issue a appropriate rating.

YOU have to notify the board in writing of your dispute and wishes to pursue the matter. In this case, the ER/IC should be liable for travel costs to return to WY for the evaluation. The comp court isn't going to be the one to follow up on this...And at this late stage in your claim, it may be difficult to find an atty to take the claim.

IME/Independant Medical Examiners should really have to see an IW face to face...IF the medical records and treating/consulting physicans narrative reports are complete. ANY doctor should be able to read those reports and make a determination to your condition and offer a valid opinion.
You have reached a stable condition..MMI... additional treatment isn't necessary on an expedient basis as your condition isn't expected to change in the next 12 months....so you are ready to proceed to some resolution of the claim.

But for the disputed issues...and you need to address those...now.

**JJS** · 08-27-2009, 09:28 AM

I have had a total of 5 ratings in 4 years. Wc is in the insurance buisness, plain and simple. They will shop you around until they find the rating that is the lowest. As for that certain rheumatologist in casper, that person was a former employee of wc. And in my opinion is in the pocket of wc. My case went in front of a medical panel, and this persons rating was tossed out. This person was also chastised for the way the rating was done, by the medical panel. These rating's are worth about 700$ to 1000$ to the doctors who are doing them. Maybe they could take a little pride in there work? Out of the 5 ive had, only 1 has been done to standard. Of coarse it was the highest and thrown out by wc. So as far as ratings go, be prepared to be shopped around. Don't settle on ratings that are done by doctors who are not qualified to be doing them!!!!

**Wagonburner** · 08-28-2009, 05:22 AM

Just wanted to say thanks for the info. I had talked to a attorney and faxed all info to him yesterday and he said that he would look into it to see what could be done. He had told me what the Drs name was before i had a chance to. Imagine that huh! Guess iam in for a long run.