Visitor Question

Can I dispute the workers’ comp rating for my injuries?

Submitted By: JC (Birch Tree, Missouri)

I was hurt at work as a paramedic lifting a heavy patient. Had my Left Labrum Repaired in April 2018. Still had issues. Had C5 – C6 Fusion in February of 2019.

I cannot extend my left arm to my left without pain and cannot even hold one pound in it. Same with extension to the front. I cannot put my arm straight up. I cannot work in very close quarters with left arm due to extensive pain. I can reach behind my back if I do it very slowly.

I cannot make quick movements with left arm such as flicking a blanket off without it feeling like someone is pulling my arm off.

I have been released back to work with permanent restriction of lifting no more than 10 pounds above my waist.

In his office, the doctor said I should not work as a paramedic anymore because I could hurt myself by trying to protect my left arm and I could end up dropping a patient. But, but did not state this in his report.

I have been given 10% rating for my neck, which I am fine with. But I have been given a 12% rating for my left arm. How can I have a permanent restriction and in reality only have about 50% use of my left arm but only have 12% rating? Can I dispute this?

Thanks for anything you can tell me.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear JC,

It appears from your question that the workers’ compensation physician has placed you in a difficult spot. The permanent partial disability rating he has assigned you doesn’t seem to match the limitations he has placed on your ability to continue to work as a paramedic.

The vast majority of states use the AMA (American Medical Association) Guides to the Evaluation of Permanent Impairment as the basis for determining a disability rating.

According to the AMA Impairment Guides Overview, the Guides “provide a reliable, repeatable measurement framework for permanent impairment in patients who have suffered an injury or illness resulting in long-term loss of a body part or reduction of body function.” The Guides, however, do not eliminate a doctor’s discretion in assigning a disability rating.

Choosing Your Doctor

In Missouri, the employer has the right to choose the treating physician or other healthcare providers to examine and treat you related to a workers compensation claim.

The Missouri statute that applies to your situation states:

“In addition to all other compensation paid to the employee under this section, the employee shall receive and the employer shall provide such medical, surgical, chiropractic, and hospital treatment, including nursing, custodial, ambulance and medicines, as may reasonably be required after the injury or disability, to cure and relieve from the effects of the injury.” 

In reality, your treating physician is often chosen by the insurance company who insures your employer for workers’ compensation claims.

The right of the employer to choose your workers’ compensation doctor doesn’t stop you from getting a second opinion from a physician of your own choosing. Under Missouri law, you have the right to select a treating physician — at your own expense.

Missouri law provides:

“If the employee desires, he shall have the right to select his own physician, surgeon, or other such requirement at his own expense.” 

For many people this is not a real choice because of the expense involved. The financial ability to choose your own physician may depend upon whether your health insurance policy covers treatment required because of work related injuries.

Challenging Your Disability Rating

One potential option for challenging your disability rating is through the Missouri Department of Labor’s Dispute Management Unit.  That unit is responsible for providing information and attempting to resolve disputes between injured workers and the employer/insurer prior to a case going to litigation.

The Dispute Management Program is designed to mediate disputes that arise soon after a workplace injury occurs. The Division has one mediator who assists parties in resolving medical treatment and lost wage disputes. This is a voluntary process and both parties must agree to mediate.

If your employer or its insurance company will not agree to mediate, then you have the option to request a hearing before an Administrative Law Judge. Be aware, however, that this program is available only if you have not filed a claim and started a contested case.

More info about the Dispute Management Unit, the mediation process and Missouri workers’ compensation law can be found at the at Missouri Department of Labor website.

Based on your question, it sounds as though you have not filed a claim and are not being represented by an attorney. Issues of disability ratings, employment limitations and what compensation you are entitled to receive can be difficult and involved. An experienced workers’ compensation attorney could be invaluable in helping you to address these issues and get the fair treatment you deserve.

Learn more here: Worker Partial Disability Claims

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney.

Find a local attorney to give you a free case review here, or call 888-972-0892.

We wish you the best with your claim,

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