{"id":4008,"date":"2016-07-25T11:00:18","date_gmt":"2016-07-25T15:00:18","guid":{"rendered":"https:\/\/joemillerinjurylaw.com\/?p=4008"},"modified":"2016-07-27T11:05:53","modified_gmt":"2016-07-27T15:05:53","slug":"rating-guide-criteria-for-doctors-in-nc-workers-compensation-cases","status":"publish","type":"post","link":"https:\/\/joemillerinjurylaw.com\/rating-guide-criteria-for-doctors-in-nc-workers-compensation-cases\/","title":{"rendered":"Rating Guide Criteria for Doctors in NC Workers\u2019 Compensation Cases"},"content":{"rendered":"

The North Carolina Industrial Commissions provides guides<\/a> to physicians for determining how to rate the impairments for specific types of injuries. The guidelines are just a starting point and not a precise definition. Doctors who are making an evaluation of the impairment rating of a worker can use the guides but they should also factor in the intangible factors such as the amount of pain the worker can endure, how weak the employee is, the dexterity of the worker and other factors.<\/p>\n

The guides are for injuries to the upper extremities, lower extremities and the spine. In North Carolina work injury cases, the doctor examines the affected body part and then assigns an impairment rating based on how well or how poorly the worker can use that part. Oftentimes, the doctor defers to a functional capacity examination (FCE)<\/a> to help determine the level of loss of function. For example, the doctor may say the worker has 20% permanent impairment in his or her right upper extremity (arm). The impairment rating is just one factor in the amount of wage loss benefit the employee will get and the length of those benefits.<\/p>\n

The final impairment rating should be based on the physicians\u2019 knowledge, the clinical examination of the patient, and the doctor\u2019s experience.<\/p>\n

Some Recent Concerns by Doctors about the North Carolina Impairment Requirements<\/h2>\n

Some of the more recent issues that doctors and lawyers have raised about when and how to do their impairment ratings are:<\/p>\n

Rating and Release<\/h3>\n

Due to some changes in the law, impairment ratings are becoming more and more important in North Carolina work injury cases.<\/p>\n

Recent changes, for example, allow a worker to be forced to engage in \u2018fake\u2019 jobs if some residual disability prevents him from actually getting and keeping a job, and the doctor agrees it would help the injured worker, regardless of whether or not he has reached “maximum medical improvement”. This change has meant more litigation, between the employer and claimant, about the ability of the worker to perform the tasks in a given available job. The ratings, along with the analysis of the worker\u2019s physical limitations can help or hurt the employee\u2019s argument that he\/she is not able to do the specific available job.<\/p>\n

The rating can be given when the patient has reached maximum medical improvement even though the doctor may have already concluded that additional surgeries or additional medical treatments will not help the worker.<\/p>\n

The North Carolina Industrial Commission guidelines for impairment ratings<\/a> are not the same as the American Medical Association ratings. There is not a direct correlation between the two. Doctors, in North Carolina work injury cases, should begin with the Commission guidelines because those guidelines were designed to match the North Carolina Workers\u2019 Compensation<\/a> Statute.<\/p>\n

The Right of the Worker to Get a Second Opinion as to a Rating<\/h3>\n

The employer is obligated to pay for the first medical opinion and treatment as to any permanent partial impairment. The employee can get a second medical opinion with a doctor of his choosing only as to the rating \u2013 at the employer\u2019s expense, after the employer obtains a rating and where the worker is dissatisfied with the impairment rating offered by the worker\u2019s original treating doctor. The employer and insurance carrier can also request that a second medical opinion be obtained. In some cases, such as where the worker does not have legal counsel, the Commission may recommend that there be an independent medical opinion. Litigation often centers around the situation where the two medical opinions contradict each other. Workers should review the right to a second opinion with an experienced North Carolina Workers\u2019 Compensation attorney.<\/p>\n

For a more in-depth discussion of your rights to a second opinion under NC Workers Comp Law, Click Here.<\/a><\/p>\n

Medical Records<\/h3>\n

The medical provider should understand that the following people are entitled to medical rehabilitation records, the testimony of the doctor, and the opinions of the doctor \u2013 as a matter of course:<\/p>\n