If you’re hurt at work, injured in a traffic or trucking accident, or hurt in another type of accident, a key factor in the amount of your settlement is whether your injury is permanent and if so, the medical severity of the permanency.
The answers to these settlement-driving questions are between you and your doctor. It’s your job to thoroughly and honestly tell the doctor your symptoms and the impact they have on your life. It’s the doctor’s job to take your reports, plus the medical evidence, and produce a measure of your injury’s permanency. Let’s take a closer look how that works.
First Things First
Your doctor can’t reach the conclusion that your injury’s permanent until you’ve reached maximum medical improvement (MMI).
MMI means your condition is as good as it’ll get from a medical standpoint. In other words, further treatment won’t make it better. But that doesn’t mean doctors give up. You might still need future treatment to prevent worsening or to address inevitable worsening caused by the injury. For example, some shoulder rotator cuff injuries are so severe they eventually create the need for a shoulder replacement. Future treatment can be a part of both accident injury and workers’ comp settlements.
If the doctor finds you’ve reached MMI and your injury’s permanent, she gives you a permanent impairment rating.
Where does that come from? The book, of course.
The Book on Permanent Impairment and How It Works
The American Medical Association wrote “the book” about permanent injury severity. It’s called AMA Guides to the Evaluation of Permanent Impairment, also known as the AMA Guides. Doctors are supposed to follow it to give an accurate rating.
Here’s how it’s basically designed to work:
- What does the rating mean? It reflects the severity of impairment and resulting disability. The disability is usually expressed as the loss to a whole person. But for some body parts like arms and legs, the disability is limited to that body part. I’ll show you what that means, but first…
- What does a permanent impairment rating look like? It’s a percentage. So as a simple example, an injury to the lumbar (lower) spine could be stated as a “25% impairment to the whole person,” but an arm injury would be expressed as “13% to the right arm.”
What Doctors Base Permanent Impairment On
According to the AMA Guides, it’s the doctor’s job to give an unbiased assessment of your condition, including its effect on your ability to function and do basic daily activities. The AMA Guide instructs doctors to base ratings on four basic considerations:
- Your diagnosis,
- Symptoms and disability reported by you,
- Exam findings, and
- Results of clinical studies.
Here’s a little about each:
- Diagnosis – This is the most important factor. Without an accurate diagnosis, there can be no accurate rating.
NOTE: the next factors can be critical, as the AMA Guide gives a range of ratings for injuries. These factors can determine where the final rating falls within the range. To help the doctor assess these factors, she may order a functional capacity evaluation.
- Functional History – This is based on your reports of your limitations. Sometimes doctors use questionnaires or a functional capacity evaluation to score this.
- Physical Exam – These are results of the doctor’s exam of you that confirm or refute the diagnosis.
- Clinical studies – These are tests like x-rays, CT scans, or MRIs that confirm the diagnosis and/or show the severity of your condition.
After the doctor considers all of this, she gives you a rating.
The question becomes, what do you do with it? That’s where an experienced injury lawyer can really help you. It’s your attorney’s job to paint the full picture and show how your permanent injury impacts your life. That’s often the most important thing we do to maximize the value of our clients’ cases.
If you’re confused or worrying about handling your permanent injury case, fill out our Get Help Now form to get all your questions answered by an experienced injury attorney.