What is an Impairment Rating in a Workers’ Comp Case?
If you suffer an injury on the job in Arkansas, you want to get healed quickly, so you can return to work and resume your normal daily activities. Your employer and their insurer want this too. The faster you return to work, the faster they can stop paying your workers’ compensation claims. However, what happens when your injuries don’t heal or when you suffer permanent or total disability?
When this occurs, your doctor must rate your impairment. This impairment rating helps to determine how long you can receive workers’ compensation benefits and how much you are entitled to receive. Each impairment has a dollar value, and the degree of impairment also matters. Your employer’s insurance company will use this impairment rating when calculating your benefits.
Often, the insurance company and injured worker do not agree on the extent of the injury or the level of impairment. This is where an impairment rating helps. The rating will tell the insurer and your employer if you cannot return to work or return to work in a lighter capacity. This impairment rating is critical when it comes to receiving all the benefits you are entitled to, including workers’ compensation claims, SSA disability benefits, and other employment benefits.
What is an Impairment Rating?
In Arkansas Workers’ Compensation cases, an injured worker may get released by their doctor at maximum medical improvement (i.e., as good as you are going to get). When this happens, the doctor will assign an impairment rating.
An impairment rating is a measure of the level of impairment, so the worker, employer, and insurance company can all understand the severity of the injury. They may determine that you are partially or totally disabled because of your workplace injury.
When you hear the word impairment, it is important to understand that there are differences and degrees of impairment.
- Permanent impairment. This type of impairment lasts forever. For example, it could be a loss of motion or a loss of strength in a hand or arm.
- Temporary impairment. This type of impairment will not last forever. There are many times when an injury results in an impairment for a specific amount of time. An example of a temporary impairment is a worker who fractures their hip. This type of injury will result in significant impairment, but they can make a full recovery with the right therapy and help.
- Partial impairment. This type of impairment only affects a specific part of the body, such as the loss of eyesight in one eye or hearing loss in an ear.
- Total impairment. This type of impairment affects the entire person. An example of total impairment would be someone with a spinal cord injury.
Permanent and total impairment gives workers the ability to pursue longer and larger workers’ compensation benefits. Permanent impairments must also receive impairment ratings to help determine the full scope of benefits an injured worker qualifies for.
The Impairment Rating Process
A medical impairment rating gives insurers a percentage of the level of impairment a worker has suffered. This impairment rating helps them determine how much the impairment will affect the employee’s ability to return to work. If the workers can return to their job in a lower-paying or less stressful capacity, they are considered partially disabled. If they cannot return to work in any capacity, they are considered to be totally disabled.
To receive this rating, you must have already received at least 104 weeks of benefits after an injury. Your impairment must also be considered permanent and not temporary. Once you have reached maximum medical improvement, your doctor will focus on helping you manage your injury. Full recovery will no longer be a possibility. When this occurs, you will need to enter the impairment rating process.
Scheduling an IREOnce you have received 104 weeks of benefits and are at maximum medical improvement, the insurance company will send you a notice to take an Impairment Rating Evaluation. A medical doctor will conduct this test, and you must attend this appointment, or you could lose your benefits. The reason for this IRE examination is so that the employer and insurance company can evaluate for themselves the full extent of your injuries. They often use this to try and reduce the benefits they pay to you.
The IRE ExaminationThe insurance company can request up to two IRE Examinations within a year. During this examination, the doctor will review your medical records, treatment, and therapies you attended. They will examine your impairment and your health to determine the degree of impairment you now suffer.
Calculating the Impairment Rating PercentageIn Arkansas, doctors must use a book entitled The AMA Guide to Permanent Edition, 4th Edition, to calculate that rating. This book covers every body part that could be injured, including the skin, the spine, the upper extremities, the lower extremities, etc. When the doctor assigns the rating, that rating is valued at a dollar figure. There are mathematical formulas to calculate how much your impairment rating is worth. As such, it is important to have an experienced workers’ compensation lawyer on your side throughout to ensure that your disabilities are calculated correctly and accurately.
Results of the IREThe insurer wants the doctor to rate your disability below a specific threshold so that they can move you off of total disability benefits and onto partial disability benefits. This saves them money — but it is not in your best interest.
Appealing an IREIf you disagree with the results of your IRE, you can file an appeal with the Arkansas Workers’ Compensation Commission. Filing an appeal is important because your impairment rating will directly affect how much money you receive and how long you receive it. If you want to receive maximum benefits, you will need an experienced and skilled Arkansas workers’ compensation attorney on your side from the start to fight for your rights. Your attorney can represent you through the impairment rating and appeals process.
What to Do and What Not to Do During an IRE
When you receive a notice that you must attend an impairment rating evaluation, it is important to understand how serious this examination is to your claim. Do not take it lightly. Instead, call an attorney with experience handling workers’ compensation claims. Your attorney can help prepare you for the IRE and ensure that your rights are protected throughout.
- Take a friend with you. It is important to take a friend with you to the examination. This could be a friend or family member. Your friend can help look for issues that you might miss while you are being examined. They can also take impartial notes and write down the answers your doctor is giving. Doctors are more likely to be thorough and do a fair evaluation when there is a witness present.
- Come prepared and take notes. If you are able, be sure to take notes during the examination. Ask the doctor any questions you may have about your injury or illness, and make sure you write down their answers. As soon as the exam is over, sit down and write everything you can remember about the events, including what the doctor did and how long the exam lasted.
- Be honest. It is important, to be honest with the medical doctor about your condition. Do not exaggerate your injury, but also do not downplay your symptoms. If you experience pain, be sure to let the doctor know that. If you suffer from reduced mobility, be sure you let the doctor know how your injuries genuinely affect your life and the quality of life you live.
- Ask to see the doctor’s report. After the examination is complete, ask the doctor to see what notes they wrote about your condition. This way, you can correct any misunderstandings or errors in the report. Maybe they got the date of your injury wrong or misunderstood how your injury occurred. This is the easiest time to correct mistakes before they have a chance to jeopardize your workers’ compensation claim.
- Give more information. While you should answer the doctor’s questions honestly and accurately, avoid giving more information than you need. Avoid making your own correlations or speculating on your injuries. If you have a family trip planned in a few weeks, your doctor does not need to know that.
- Forget that everyone is watching. When you go into your IRE, everyone is watching — or at least assume they are. Do not take the stairs if that is usually a challenging activity for you. Even if you are having a good day, avoid doing things that might be used against you to prove that your injuries are not as bad as they seem. You do not need to pretend that your injuries are worse, but always remember that people are watching, including nursing staff. They will note how quickly you walk, how your overall pain seems to be, and how you move.
What Can an Arkansas Workers’ Compensation Attorney Do For You?
An Arkansas workers’ compensation attorney can help you avoid the pitfalls when going into an IRE. The examination is an important part of your claim and can seriously impact the money you receive monthly. An attorney at Rainwater, Holt & Sexton can help you through this process and protect your rights at every turn.
Insurance companies and employers are reluctant to pay injured workers what they need and deserve. They often try to reduce their responsibilities by forcing workers back into the workplace too early or getting a lower impairment rating. Your attorney can make sure you are treated fairly during the process and that your impairment rating truly reflects the impact your injury has had on your life and your future.
Being dropped from total disability benefits to partial disability benefits can have a serious impact on injured workers and their families. If you receive a notice from the insurance company to attend an IRE, contact a workers’ compensation attorney immediately.
When you suffer a work injury, you deserve to collect the full amount of benefits you are entitled to. Unfortunately, workers’ compensation claims are not always cut and dry. Without suitable legal representation, injured workers may not get the benefits they need to get back on their feet and back into the workforce. These cases are critical and require a law firm with the experience and knowledge necessary to achieve successful outcomes.
With seven offices in Arkansas and Tennessee —Little Rock, Springdale, Conway, Hot Springs, Bryant, Jacksonville, and Memphis —our workers’ compensation lawyers are easily accessible when you need help.