{"id":5062,"date":"2020-11-12T12:10:47","date_gmt":"2020-11-12T16:10:47","guid":{"rendered":"https:\/\/joemillerinjurylaw.com\/?p=5062"},"modified":"2020-11-16T12:12:19","modified_gmt":"2020-11-16T16:12:19","slug":"the-american-medical-association-guidelines-and-state-workers-compensation-guidelines-for-determining-a-workers-permanent-impairment-rating","status":"publish","type":"post","link":"https:\/\/joemillerinjurylaw.com\/the-american-medical-association-guidelines-and-state-workers-compensation-guidelines-for-determining-a-workers-permanent-impairment-rating\/","title":{"rendered":"The American Medical Association Guidelines and State Workers\u2019 Compensation Guidelines \u2013 for Determining a Worker\u2019s Permanent Impairment Rating"},"content":{"rendered":"

Different federal agencies and different states use the AMA guidelines (either directly or indirectly) to assess a worker\u2019s permanent partial impairment. In the context of a workers\u2019 compensation<\/a> case, a permanent partial impairment rating\u00a0 will typically be a measure of any permanent damage or restriction that is objectively measured in a specific body part, such as the upper extremities, lower extremities, hands, or feet. In North Carolina (<\/span>not<\/b> in Virginia) this can also include permanent impairment to the spine.\u00a0 These partial impairment ratings are expressed in terms of a percentage of permanent impairment.\u00a0<\/span><\/p>\n

The United States\u00a0 <\/span>Department of Labor<\/span><\/a> has guidelines for evaluating medical evidence necessary to show a \u201cratable permanent impairment\u201d for certain federal workers. Generally, workers who have a ratable permanent impairment are entitled to additional pay after they have reached the point of maximum medical improvement.\u00a0<\/span><\/p>\n

States, such as North Carolina and Virginia, generally use comparable guidelines in determining how much, if any, additional compensation injured or ill workers should receive due to a workplace injury or disease. In Virginia, the guidelines are not specifically mentioned by statute, but are often utilized by doctors and rehabilitation professionals to assign permanent impairment ratings to the injured body parts of claimants.\u00a0 Others use their own guidelines. For example, North Carolina has its <\/span>own rating guide for impairment<\/span><\/a>.\u00a0<\/span><\/p>\n

Before we go further, one important note about impairment ratings generally: If we have an accepted claim or a claimant who is under an Award in Virginia, and the injured worker is injured to the extent that he or she cannot return to job he\/she held prior to their injury, and the employer is unable to accommodate the employee\u2019s physical restrictions, then really, except in\u00a0 rare circumstances,\u00a0 the impairment rating is not a very important item to consider.<\/span><\/p>\n

\u00a0Why? Because first, if it is an accepted or awarded claim, and one cannot return to his or her pre-injury job, and the employer is not able to accommodate, then the employee will continue to receive TTD for potentially up to <\/span>500 weeks<\/b>. So long as an injured worker is receiving TTD, then the law says he or she cannot simultaneously receive payments for permanent partial impairment (PPI) and TTD.\u00a0 In other words, one cannot ADD to the 500- week maximum with PPI payments.\u00a0<\/span><\/p>\n

Those PPI payments would only be available if, and when the injured worker returned to work at any job.\u00a0\u00a0\u00a0<\/span><\/p>\n

In addition, in the scenario of an accepted claim, we are often looking at a potential <\/span>settlement<\/span><\/a> of the claim. The value of the indemnity or \u201cweekly TTD checks\u201d portion of the claim in a case where one cannot return to the pre-injury job is usually far higher than any payment that one would be entitled to for PPI.\u00a0<\/span><\/p>\n

Accordingly, the only time PPI usually becomes more important is the scenario where the injured worker has returned to work in some capacity. Once that happens, we are going to factor those available payments into any potential settlement. In the above scenario, where the injured worker continues to receive TTD, and we are looking at a potential 500-weeks maximum of payout, we do not care as much about the ratings in any settlement scenario.\u00a0<\/span><\/p>\n

North Carolina rating guide<\/i><\/b><\/h3>\n

North Carolina distinguishes between an evaluation of permanent physical impairment and permanent disability. It references the AMA guidelines as follows:<\/span><\/p>\n

The Disability Committee of the\u00a0<\/span>American Medical Association<\/span><\/a>\u00a0(AMA) has pointed out that the evaluation of permanent disability is twofold:<\/span><\/p>\n