When you are injured at work, you can file a claim to receive compensation for your lost wages and medical expenses. But the doctor will need to determine the extent of your injury to decide how much you are eligible to receive. The determination will be contingent on your impairment rating.
This article will discuss what an impairment rating is so you know how your benefits will be determined.
Different Types of Impairment Rating
Your impairment rating is, in part, determined by how long your impairment will last and the body parts it affects. These ratings are as follows:
- Permanent Impairment: This is an impairment that will last forever.
- Temporary Impairment: A temporary impairment will not last forever.
- Partial Impairment: A partial impairment affects only a specific part of the body.
- Total impairment: A total impairment affects the entire person. A spinal cord injury is an example of a total impairment.
How is an Impairment Rating Calculated?
Impairment ratings are calculated differently from state to state. For example, North Carolina figures impairment ratings based on body parts. They assign a certain number of weeks of compensation for the loss of various body parts such as the thumb, first finger, second finger, leg, foot, eye back, and so on.
Each state has resources with mathematical formulas that tell insurance companies how much injuries are worth. It’s critical to have a worker’s comp lawyer on your side to ensure you are compensated accurately.
The ratings are calculated as percentages. They determine the worker’s ability to go back to work. If the worker is temporarily disabled, they can go back to work after healing is complete. If they are partially disabled, they may return to work at a lower-capacity position. If they are permanently disabled, they may be unable to return to work at all.
What is Maximum Medical Improvement (MMI)?
Maximum Medical Improvement is a term used to describe the end of your healing period. Some people may be fully healed after their healing period is complete. Others may be permanently disabled.
If you are permanently disabled after the healing period is complete, you will be assigned an impairment rating that reflects the change from your pre-injury condition. Impairment ratings cannot be assigned until MMI is achieved, Workers cannot receive an impairment rating until they receive at least 104 weeks of benefits.
About the Impairment Rating Examination
After 104 weeks of benefits, you will receive a notice from the insurance company to take your Impairment rating evaluation (IRE). You must attend this appointment, or you could lose your benefits.
During the appointment, the doctor will examine you to determine the extent of your injuries. They will also review your medical records and treatments. They will assign you an impairment rating based on your loss of functionality and suffering.
An insurance company can request up to two IREs per year.
The results of your IRE will help your insurance company determine whether you should continue receiving the same benefits. They can also move you from total disability to partial disability so you will receive fewer benefits. Or they may decide you are fully healed and take your benefits away.
Can I Appeal an IRE?
If you don’t think your IRE accurately represents the extent of your benefits, you can file an appeal with your state’s workers’ comp committee. It’s advisable to have a lawyer to represent you throughout the process. They will help you get the compensation you deserve.
How to Prepare for Your IRE
Doctors should look out for your best interest. Unfortunately, in a workers’ comp case, this isn’t always true. Some doctors have deals worked out with insurance companies. They will underplay a patient’s injury on reports so the insurance company can reduce their payouts. The provider sends them more patients in return.
You can avoid inaccurate diagnosis if you take the following steps:
Take a Friend with You: Take a friend or family member with you to serve as a witness during the examination. The friend can take notes to document what happened during the appointment. The doctor will be less likely to make an inaccurate diagnosis knowing there’s a witness in the room.
Take Notes: If possible, take notes during the exam. Ask your doctor questions about your injury and write down their answers. Doing so will help you recall what happened so you have an accurate account of your appointment.
Be Honest: Be honest about your injury and how it affects your life. Don’t attempt to downplay or exaggerate it.
Ask Your Doctor to See the Report: Ask your doctor to see your medical report after the exam is completed. You can correct errors regarding any misunderstandings and ensure the date of the injury and other facts are correct. It’s best to address mistakes right away so they don’t interfere with your benefits later.
Don’t Give More Information Than You Need To: Answer the doctor’s questions concisely without giving extra information. Do not speculate about your injury and how it affects you. Don’t talk about any family trips or activities you have planned.
Remember That Everyone is Watching: Everyone will be watching you during, before, and after your examination. They will look at how well you move and get around. Don’t exaggerate your injuries, but don’t pretend they aren’t there either. Don’t attempt to run up the stairs or hop on the exam table, even if you are having a good day.
Your impairment rating plays a critical role in the benefits you receive. Understanding how the process works will ensure you get an accurate rating. We wish you luck during the healing process.