Published on:

Proof of Impairment Rating in Georgia Workers’ Compensation Claims

Permanent partial disability in workers’ compensation cases are among the most common type of work injury claims. They are essentially a lump sum or structured settlement award for an on-the-job injury resulting in a disability that is partial, but permanent.concretetruck1

This figure can include money for medial and therapy bills, medications, costs for transportation to-and-from physician appointments and partial wage loss reimbursement. It is a determination – made by doctors and the industrial commission/courts – after an injured worker has attained “maximum medical improvement.” This is the point at which medical consensus is the worker is medically stable and isn’t going to improve with further treatment. It doesn’t mean treatments are complete, just that this is probably the best the worker is going to get.

So for example, a person who suffers a back injury may ultimately be assigned a permanent partial disability rating of 20 percent. That means his capacity to work is reduced by 20 percent, and he is thus entitled to compensation for coverage of all related medical bills and costs, plus a lump sum or structured payment that covers the wage loss difference of 20 percent.

Insurance companies usually dispute permanent partial disability findings, so it can often be an arduous process that involves independent medical examinations, meetings with specialists, administrative hearings and appeals.

The standard of proof to establish permanent disability of any kind is high, as the recent case of In re Workers’ Compensation Claim of Michael D. Hurt, before the Wyoming Supreme Court, revealed.

In this case, claimant worked as a truck driver for a concrete mixing company. In the fall of 2006, he was working to help unload concrete from a truck when he slipped on a big hose and fell onto his back and buttocks.

As a result, he had to undergo surgery on his back. The results were fairly good, and he received permanent partial impairment benefits as a result. A doctor assigned him a whole body impairment rating of 7 percent.

However, claimant continued to suffer additional back problems, including pain, numbness and weakness. A second surgery was performed, and the hardware installed in his back from the first surgery was removed and additional fusions were made. This improved claimant’s condition, but he couldn’t go back to work. A second permanent partial impairment rating of 9 percent was issued – two percentage points higher than before.

Another doctor assigned him an impairment rating of 25 percent. A third doctor, who did not examine him but reviewed his medical records, assigned an impairment rating of 8 percent.

After consideration of those three opinions, the state’s workers’ compensation commission sided with the doctor who assigned a 9 percent impairment rating. Claimant appealed.

The case wound its way to the Wyoming Supreme Court, which affirmed. The court noted that when a worker asserts a permanent partial impairment rating that’s higher than assigned, he or she bears the proof burden. There was no dispute as to causation, but rather to what extent he was permanently impaired.

The court noted patient was able to ambulate without assistive devices, and he showed no signs of bilateral or multiple-level radiculopathy – both of which are necessary to achieve a higher rating.

Therefore, he failed to meet his proof burden.

People who suffer a work injury in Atlanta have a better chance of proving a higher permanent partial disability rating if they work with an experienced workers’ compensation lawyer.

For information on Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-303-7770.

Additional Resources:

In re Workers’ Compensation Claim of Michael D. Hurt, Aug. 14, 2015, Wyoming Supreme Court

More Blog Entries:

Walker v. Tensor Machinery – Apportionment in Third-Party Liability, Aug. 6, 2015, Georgia Work Injury Attorney Blog