Impairment Ratings

One of the most important parts of a workers compensation case is the “impairment rating”. If you have finished medical treatment but will never completely recover from your injury, you may receive some kind of impairment rating from a doctor. An impairment rating measures how much function you have lost from a body part or the body as a whole. It is then your lawyer’s role to turn that impairment rating into a disability rating, which a crucial factor in determining the final settlement value of your claim with your employer’s workers compensation insurance carrier. There are hundreds of issues that could come up related to impairment ratings, but here are a few examples of a few common problems and solutions:

1. Problem: The treating physician gives you a 0% impairment rating, but also lists that you have permanent restrictions such as you are unable to lift objects over your head. Solution: Either send the treating physician a Form 14b (one of the standard forms created by the Workers Compensation Commission) with a cover letter explaining the inconsistency of his rating report, or get a second opinion from a physician who is familiar with workers’ compensation impairment rating reports.
2. Problem: The treating physician bases her impairment rating on the American Medical Association’s Guides to the Evaluation of Permanent Impairment 6th Edition. The 6th Edition reportedly lowers the impairment ratings by up to 40% as compared to the 5th Edition, especially for spinal injuries. Solution: Either send the treating physician a Form 14b with a cover letter explaining that you need the rating to be based on the AMA Guides 5th Edition or go to a different physician who will use the AMA Guides 5th Edition.
3. Problem: You get an Independent Medical Examination (“IME”) and the bill for it is over $1,000.00. An IME is an opinion from another doctor about your impairment. If this charge shows up on your Statement of Costs, expect the Commissioner to inquire. Solution: When the Commissioners make this call, they are not necessarily trying to remove this expense. Be prepared to explain why an Independent Medical Examination was necessary and if appropriate, tell the Commissioner how the IME benefited the case (i.e. higher settlement offer).

Workers Compensation in South Carolina is an area of the law that has unique legal problems. George Sink, P.A. Injury Lawyers deals with these sorts of problems all the time. Before you get lost in the maze of the workers’ compensation system, please contact us.

The information relayed in this blog is for educational purposes only and is not legal advice. The cases referenced and explained by the blog’s author(s) are for informational purposes only and are not intended to imply that certain, or similar, results may be achieved in each client’s case.