Impairment Ratings in Workers’ Compensation Cases – Is Yours Correct?
What is an impairment rating?
In a Tennessee workers’ compensation claim, one of the most important variables that determines what an injured worker can receive in a monetary disability award is the permanent partial impairment rating assigned for the employee’s injury. Making sure our clients receive the correct rating is one of the many ways that we fight for them.
In Tennessee, a doctor places an injured worker at “Maximum Medical Improvement” (MMI) when the employee has made as much of a recovery as then can from their injuries. This does not mean that the employee is fully recovered and at the same level of health they had before their injury, but it does mean that they have reached a plateau in treatment, and there is nothing more medically that can be done to provide additional recovery. Some people continue to see their doctor after reaching MMI, others are referred to pain management, and others don’t need to see a doctor again.
What happens when you are released at MMI?
When the doctor releases the employee at MMI, the doctor is then required to complete an impairment evaluation. In Tennessee, the doctor is currently required to use the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Sixth Edition. This book, all 600-plus pages of it, tells a doctor what kind of impairment percentage a person retains after an injury.
We have multiple copies of the Guides here at Rocky McElhaney Law Firm. The main reason for this is so we can double check our clients’ doctors when they assign ratings. It is an unfortunate fact that some doctors in Tennessee either do not know how to properly use the Guides or missed something in their evaluation (whether that is intentional or unintentional depends on the doctor).
How can you identify an error in my assigned impairment rating?
When a client of Rocky McElhaney Law Firm is assigned an impairment rating by their treating doctor, our support staff requests all of the doctor’s records to go along with the impairment rating. Once we have received everything, the file is reviewed by the attorney handling the claim. We make sure to read the complete records to look for anything that could impact an impairment rating and then double check the doctor’s rating.
What mistakes are most commonly made by doctors in assigning an impairment rating?
The most often mistake I have found in my time with the firm is when a doctor does not evaluate an injured worker’s loss of range of motion in an injured shoulder. The Guides have some very specific rules on how the doctor is supposed to measure range of motion. For the shoulder, there are six different types of measurements. The Guides require the doctor to use a tool called a goniometer, which is like a ruler or a compass, to take the measurements. The Guides say that a doctor has to take each of the six measurements three times apiece after having the patient warm up. There are a number of ways a doctor can fail to properly do his evaluation. Sometimes doctors do not take measurements at all, other times the doctor uses what we call the “eyeball method” and doesn’t use the goniometer, and many doctors forget that they need to take all six measurements three times each.
What happens when an error is found?
When a Rocky Law Firm lawyer catches an error like this, we first try to point it out to the doctor and ask him to provide a rating by following all of the rules the Guides provide for the body part at issue. Sometimes this works, but other times the doctor digs in and will not change an improperly computed rating. In that situation, we will might send the client to an independent medical doctor for a proper evaluation. These independent evaluations aren’t necessarily the right fit for every case, so it becomes a case-by-case decision. Your case is as unique as you, and that means what is best for one case might not be the right move in another.
Impairment ratings impact your compensation
Impairment ratings play a big part in determining how much money an injured worker gets at the end of their workers’ compensation claim. Because of that, we make it our business to make sure our clients’ ratings are done correctly. I remember a gentleman came in to meet with us, having already been released by his doctor with an impairment rating. The insurance company made him an offer based on that rating and he didn’t know if he should take it or not. As it turns out, the rating was incorrect, and after obtaining the correct rating with an independent medical evaluation, we were able to get that insurance company offer doubled. While that isn’t the case with every client, we still double check every rating to make sure our clients get the benefits to which they are entitled.
If you or someone you know has been injured while working, please give us a call. We’ll fight for you every step of the way.
As a seasoned Senior Associate with Rocky McElhaney Law Firm, Steve Fifield’s highly-specialized practice focuses on workers’ compensation and complex personal injury claims. Steve Fifield has also worked with Rocky to develop a practice focusing on assisting injured workers who have resolved their claims in the past but are currently being denied needed medical care by an insurance company in violation of Court orders.