Texas impairment rating of 0??

[froglett]

I injured my ankle, leg, knee and hip in December. The first mmi exam by my doctor in March said I was not at mmi, my insurance co requested a designated doctor who agreed and they both ordered an mri. The mri showed the beginning of tendinitis, some sort of thickening of something, intramuscular tearing and fluid build up. After 3 more months of therapy, I still have the same problems. Pain and swelling when I walk or stand for any periods of time, pain at night, pain when driving. Pain and swelling period. My dr did another mmi and gave me a whole body ir of 15. All of the exams thus far by both drs were thorough, and took over an hour. My insurance company requested another designated dr. This one was a joke. He spent 45 minutes telling me how workmans comp works in detail, and about himself, he was an ob doctor before he started doing this. He used a plastic ruler and a protractor, and spent less than 10 minutes on the exam. His questions were leading, he completely ignored the things that caused me pain, and even though my ankle was swollen during the visit, he was careful to take measurements above that, barely mentioning it in his report. I told him that I had quit my job to help my husband start his new business. He asked if there were any problems doing that. I said no, because when I started hurting, I could go lay down, the only problems I had was when I had to drive for him. I ALSO told him that this was temporary, that I was not making any money doing this and would have to find another job that did include walking and standing, which caused the pain. I was trying to be honest. He ignored everything that I said hurt, told half truths and lies in his report and gave me a 0 impairment rating. My doctor is helping me fight this, does anyone know what I can expect?

[sparkey]

First I do not have a lawyer. Something I wish I would of got. I had my hearing 2 weeks ago because of a rating dispute. My doctor was 32% and IME doctor was 10. Because of the difference in ratings, the labor board forced the IC to call a hearing.

I am still waiting that result. Hopefully any day I should get it, and could tell you more. You will need to get another doctor to do a rating. THis way you will have 2 doctors on your side and theirs. The more the better. I should of had another doctor do my rating also. Learned this alittle to late. I knew you were talking about the IME doctor as they are paid to say the things they say to save the IC money. They are paid well to do that for them. The same happened when they sent me to their doctor. I do not understand how the courts could believe these doctors after knowing why they say the ratings are lower etc. Just is not fair to the patient.

You will probably need another opinion. I will let you know how my hearing worked out on my rating dispute. Now that they put you at 0,. the ic could refuse to pay for meds, treatments now. Mine is trying to stop everything because of the IME results.

[AQA]

You will need to have another doctor do an impairment rating. You can and should contact the the state and let them know that you are disputing the rating. You are on a time limit. I forget the exact time limit but it should be written some where in the rating letter

Do not let the impairment rating of others cloud you mind. Texas still uses the AMA 4th edition. When/if you contact the state, you can request to speak with an obudsman. They can point you in the right direction and help you fill out paperwork. They can not give you legal advise but they can explain things to you.

[froglett]

Thanks, redneck. My dr. is helping me dispute it. Both drs were certified to do the exam. And both drs supposedly used the same ama 4t edition. My dr said that the designated dr contradicted himself over and over in his report. Part of the lecture the designated drs 45 minute lecture was about how he was supposed to be neutral, and that is what I don't get. It was the most slanted exam and report imaginable. He actually twisted what I told him to make it sound like I was fine. He omitted things that showed there was damage done, and although he mentioned the findings of the mri, he totally disregarded them in his evaluation. It showed that permanent damage had been done. I understand a lower impairment rating than my dr gave, but a zero is ridiculous considering the problems I am still having. It was extremely obvious that he was not neutral like he claimed, but why in the world would he do that?

[froglett]

Oops, I missed a post. Another opinion? Do I just ask for that? I was told that the designated dr did not work for the insurance company, but that has to be some sort of joke. My doctor said that the mri clearly indicated that damage was done and fully supported my symptoms. I am meeting with him today, I think he wants to do another type of test. He is very supportive, and really seems to know what he is doing. I just blows my mind that the designated dr is such a quack. He rented office space, had absolutely no equipment to do an evaluation, and was actually an obstitrician. My doctor had all of this computer equipment to measure everything, and the first designated dr had a therapist and all of this wierd equipment to take tons of measurements before they did a physical evaluation. Both of the first drs had therapists to do part of the exams. The quack had himself, a ruler, a protracter, and about 5 minutes. Also, when they first set up the exam, I was told I could not go back to the first dr because of time conflicts. The first thing the second des. dr did was move my appointment back 2 weeks. He did that the day after the appointment was set. I think I was being manipulated.

[sparkey]

I just had my impairment rating dispute hearing a few weeks ago. I was asked that question about equipment used by both doctors. My doctor rated me with 32% and theirs 10%. My doctor had so much stuff on the table like he was preforming a surgical procedure. He was very good and it lasted about 1 1/2 hours.

The IME doctor I went to for the IC had one hand machine for squeezing to measure my strength. He spent all but 10 mins with me and was on the phone with his daughter talking about vacation. Probably with the money the IC was going to pay him for my exam.LOL.

I have not received the verdict yet about my rating, but will let everyone know as soon as I hear something. I am very curious on how they take the word of the injured person over the IME doctor that was paid big bucks to lower my rating.

I wrote to my doctor that did my rating, asking him to read the results of the IME doctor and please make his comments. He was totally on my side and even mentioned this doctor did not preform the test requested from the AMA guidelines. We use the 5th edition here in NH.

A second opinion of a exam or a back up note from your treating doctors would be very helpful at this point. The more the better. I had very little time to gather all this info on my own, but did it just in time for my case. The labor board forced the lawyer/IC to request a hearing because of the difference in ratings. Let's hope this is to my advantage.

[froglett]

sparkey Wrote:I just had my impairment rating dispute hearing a few weeks ago. I was asked that question about equipment used by both doctors. My doctor rated me with 32% and theirs 10%. My doctor had so much stuff on the table like he was preforming a surgical procedure. He was very good and it lasted about 1 1/2 hours.

The IME doctor I went to for the IC had one hand machine for squeezing to measure my strength. He spent all but 10 mins with me and was on the phone with his daughter talking about vacation. Probably with the money the IC was going to pay him for my exam.LOL.

I have not received the verdict yet about my rating, but will let everyone know as soon as I hear something. I am very curious on how they take the word of the injured person over the IME doctor that was paid big bucks to lower my rating.

I wrote to my doctor that did my rating, asking him to read the results of the IME doctor and please make his comments. He was totally on my side and even mentioned this doctor did not preform the test requested from the AMA guidelines. We use the 5th edition here in NH.

A second opinion of a exam or a back up note from your treating doctors would be very helpful at this point. The more the better. I had very little time to gather all this info on my own, but did it just in time for my case. The labor board forced the lawyer/IC to request a hearing because of the difference in ratings. Let's hope this is to my advantage.

[froglett]

Exactly, sparky. The same exact thing. He used a plastic protractor and ruler, and a measuring tape. The actual exam lasted about 10 minutes. He would barely, very lightly touch me and ask if that hurt. I should have screamed in pain. Just kidding, barely. I saw my doctor today to discuss everything. The doctor that gave me the 15 ir is a designated dr with my state. He told me he was conservative, and used 4th edition ama guidlines which the second dr also claimed to use. They sent a rebuttal letter to wc, and said that now wc would request some sort of clarification reports and he ordered nerve ending tests. Overall your situation is very similar to mine. I am very curious to hear your outcome. If you read this and would, I would love it if you contacted me with the results, if you can.

[UndercovrAngel]

In the state of TX..designated Dr's are not chosen by the IC, but by the state department for injured workers. They are to be totally unbiased in their opinions.

A good way to dispute the DDE is by getting your treating Dr to order a computer generated FCE (functional capacity evaluation). If you try and cheat on this test the computer will catch it. There is no way that you can trick it..as you can a human (after all, humans have been known to err).

I am also in TX and had a DDE on the 15th of May. Was told that I would have the results within 10 days. Still haven't gotten the results 2 months later. The TDIW has sent in paperwork to censure the DDE as well as fine him and take away his rights to perform DDE's. I am in the middle of a denied claim and was to have had a BRW (benefits review conference) last Thursday. The attorney (for the local ER) that originally petioned for this hearing cancelled at the last moment. It has now been rescheduled for September 2nd at 10:00 am. In the meantime, the treating Dr who is seeing me (can't do a lot of things because it is a denied claim and personal insurance won't pay anything as I am contesting it) had me undergo an FCE on the 28th of May. It came back showing that I have lost 70% of the use in my right hand and arm and that I can't even do sedentary work. If the Dr had his way, I would be out of work right now. But can't afford to loose what little I earn right now, nor my benefits that are paying for other medical conditions at this time.

My attorney believes with the results from this FCE we will be able to make the IC accept the claim and pay me back travel pay for the three trips that I have had to make to Ft. Worth so far, as well as continue to pay for all remaining trips and at least 1 meal a day ($12.00) as I am diabetic and it is a 4 hour round trip to see the Dr. Add in my TIB's at 75% of pay at time of injury, and I will be making more being out of work, than I do sitting at work 8 hours a day, 5 days a week.

I just wish that something would happen so that I can get some kind of treatment. This all began back on February 6th and I haven't had anything but a shot of toradol in the ER, a DDE exam and an FCE. My hand, wrist,arm and shoulder are getting worse everyday.. and with the way this is going.. I may not be using it at all by the time we get the claim accepted.

Angel ^j^