How Are Impairment Ratings & Disability Determined?

The Occupational Safety and Health Administration, which handles workplace safety issues, is one of the smallest federal agencies. Even with its state partners, OSHA only has one inspector for every 59,000 workers. As a result, workplace injuries are fairly common.

These victims have access to no-fault benefits that take care of their medical bills, lost wages, and other economic losses. Illinois workplace injury victims also have the right to choose their own doctors. So, a workers’ compensation attorney can connect victims with top physicians in a certain injury field.

Yet despite their best efforts, some job injury victims never fully recover. Even though they reach their MMI (Maximum Medical Improvement) levels after many months of physical therapy, some disability remains. The resulting impairment rating governs the amount of benefits the victim continues to receive. Here’s what you need to know about how impairment ratings and disability are determined.

Impairment Rating Basics in Illinois

Permanent impairment situations are particularly common in shoulder, knee, and other joint injury situations. If a victim fails to make further progress in physical therapy, a doctor assigns a permanent impairment rating.

As an example, assume Samir fell and broke his shoulder. With help from his doctor, the bone healed and he recovered most functionality. But the shoulder’s range of motion is still limited. Samir can’t move it as much as he could before, he cannot do as many pushups as he did before, and the shoulder hurts when he pushes it too far. So, a doctor determines that Samir has a 10 percent permanent disability rating.

Impairment Rating Issues

To determine these ratings, most doctors use The Guides to the Evaluation of Permanent Impairment or a similar medical publication. But such guides have some weaknesses. In many cases, they are several years old, so they do not always include the latest medical knowledge.

Additionally, they foster a one-size-fits-all environment. Let’s return to the example of Samir. If he is a white-collar professional, a slight shoulder impairment may not be a significant issue. But if he is a blue-collar worker, a 10 percent disability rating may not adequately compensate him.

Finally, there may be an issue with the preliminary MMI determination. Physical therapy progress is not always a straight line. Typically, progress comes in fits and starts. So, just because the victim has made little progress in recent weeks does not mean the victim has reached MMI. Another breakthrough may be just around the corner.

There may be a personality conflict as well. Not all therapists connect with all patients. So, instead of giving up, it may be better to change the lineup. A new therapist might be able to motivate the patient or use some more effective techniques.

How Can an Attorney Help?

In many cases, physical therapy is the most expensive component of workers’ compensation medical expenses. So, many insurance companies are quick to pull the financial plug. An attorney can fight for victims to help ensure that the MMI determination does not come too quickly.

An attorney can also help determine a proper impairment rating. As mentioned, the rating only considers some medical angles. The rating must not only consider medical nuances, but also the victim’s overall occupational and lifestyle situation.

Get Legal Help Today

The MMI/impairment rating process has permanent consequences for injured victims. For a free consultation with an experienced workers’ compensation lawyer in Chicago, contact Coogan Gallagher today.