Georgia Workers' Compensation Advocate : Augusta Attorney & Lawyer for Workers' Compensation in Georgia

 Dear Mr. Hawkins: An insurance adjuster said to me that my permanent disability rating was about 10% and that entitled me to $5,000. What is a permanent disability rating and how do I know they are telling me the truth? -Craig, Thomasville, GA

Thank you for your question Craig. I imagine this particular adjuster threw this number at you as a settlement offer? If so, do not sign anything and do not accept this amount without talking to an experienced workers' compensation attorney. Permanent partial disability is another benefit injured workers are entitled to under the Georgia Workers' Compensation Act that insurance adjusters do not want you to know about. About the only time they will tell you about permanent partial disability, or PPD for short, is when they want you to settle the case and they know you are unrepresented by counsel. 

A permanent partial disability rating, or "PPD" rating, should be issued by the authorized treating physician when the injured worker reaches maximum medical improvement or "MMI." MMI does not occur until your doctor, or medicine in general, has nothing left to offer you to make you better. The rating is a percentage of permanent impairment the injured worker has sustained as result of the workers' compensation accident. It is often issued either to the body part injured or to the body as a whole. For example, one may sustain a 40% impairment rating to the body as a whole for a serious leg injury or an 85% impairment rating to the lower extremity. Under Georgia law, the percentage is then multiplied by a certain number of weeks under the Georgia Workers' Compensation Act. The Code section which provides these numbers is O.C.G.A. Sec. 34-9-263 which can be viewed by the public for free here. That number is then multiplied by the injured workers' comp rate (which is the same as the injured workers' temporary total disability rate - see "How Much Do They Owe Me? Calculating Your Workers' Comp. Check in Georgia."  article on this site). That amount is how much money an injured worker is entitled to under the Georgia Workers' Compensation Act for their PPD rating; however, that is not the full extent of the value of the case, and you should not settle your case for that amount.

An experienced workers' compensation attorney will review the doctor's permanent partial disability rating and compare it to the American Medical Association's Guides to the Evaluation of Permanent Impairment, 5th Ed. to ensure the injured employee is receiving a fair rating. Additionally, an experienced workers' compensation attorney will review your average weekly wage to ensure your comp rate is accurate under the law. Often, the insurance company makes a mistake or intentionally miscalculates your average weekly wage to save money. Several other factors need to be considered when settling a case for a lump sum settlement. These other factors will have a significant impact on how much you are entitled to under the Georgia Workers' Compensation Act. If you have sustained a work-related injury, and have been offered a settlement based on the insurance company's estimated average weekly wage, comp. rate, and/or permanent partial disability rate, I recommend you talk with an experienced workers' compensation attorney prior to accepting or signing anything. If you would like to discuss your case with me at no obligation, please feel free to call either one of our offices today. The consultation is always free and will remain confidential until you instruct us otherwise. 

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One of the most common injuries I see as a Georgia workers' compensation attorney are shoulder injuries. Given that most employees are constantly using their arms for heavy or repetitive lifting, I am never surprised to get a new shoulder case. Sudden movement of the arm can cause a dislocated shoulder, torn rotator cuff, partial rotator cuff tear, and so on. Shoulder pain is a serious symptom that should be taken seriously because early intervention can reduce the risk of further tearing of the cuff and permanent partial loss of the upper extremity.

The reason why the shoulder is so vulnerable to injury is because the ball of the upper arm is larger than the socket, and often the ligaments, tendons, and muscles which hold your shoulder in place are damaged from repetitive activities or over extension of the arm. This can cause the ball to literally come out of the socket and damage the shoulder. The most common shoulder injuries include strains, sprains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures, and aggravation of preexisting arthritis (which is also compensable under the Georgia Workers' Compensation Act). While the tendons can be a source of the pain, the muscles around the socket are usually the root cause of a serious shoulder injury and the most commonly injured rotator cuff muscles are the supraspinatus and infraspinatus muscles.

Doctors will usually treat shoulder injuries with conservative treatment first. Conservative treatment consists of rest, ice, compression, and elevation (RICE) until an exact diagnosis can be given. In some cases, physical therapy and injections into the shoulder may relieve the pain; however, if conservative treatment fails, an MRI of the shoulder should be ordered by the treating physician to examine the joint for significant damage. More aggressive treatment usually includes surgery to repair the shoulder if a rotator cuff tear or a partial rotator cuff tear can be identified on MRI. In rare cases, a surgeon may perform exploratory surgery if an MRI is negative, yet pain persists and the injured worker has a loss of their range of motion. 

The road to recovery for serious shoulder injuries can be long and difficult. Injured employees must be patient and follow their doctor's orders to obtain the best results. However, in many cases the shoulder never returns to pre-injury status and use of the upper extremity is occasionally permanently restricted.

 

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So what is an Independent Medical Examination (IME)? And why is it so important in Georgia workers' compensation claims? The answer is not simple, because the IME is utilized by the employee's attorney and the employer's attorney for very different reasons.

An IME is an opportunity to have a different doctor physically examine an injured worker and review their medical records and diagnostic tests for the purpose of providing a second opinion. The IME doctor should make a diligent effort to address some of the issues the patient is having and try to figure out what is or is not going right medically speaking. He or she may also address the injured worker's current work restrictions, treatment options, the necessity of a recommended surgery, and when applicable, the injured worker's permanent partial disability rating if one has been issued.  

From my perspective, as an attorney who only represents injured workers, I use the IME in three situations. First, when I find a client's diagnostic tests are consistent with a serious injury (usually through x-rays, CT scans, EMG's, or MRI's), but the treating physician is skeptical of the employee's complaints of pain or the doctor's specialty does not focus specifically on the type of injury my client has sustained, I recommend an IME to confirm or dispute the treating physician's opinion on the case. Occasionally, the authorized treating physician will take offense to the IME. However, I make every effort to explain the purpose of the IME to the treating physician whenever possible. My job as an attorney is to zealously represent my client and in some cases that involves double-checking a doctor's findings with an equally qualified peer unassociated with the treating physician's practice or a specialist who works primarily on the type of injury sustained. 

Second, I will recommend an IME even where I know I have a good and reputable doctor treating my client, but my client is still doubtful of the diagnosis, treatment options, or work restrictions. In that case, I will recommend an IME for the sole purpose of addressing my client's concerns. As any doctor knows, peace of mind for a patient is a part of the healing process. Further, I feel as though what sets a good workers' comp. lawyer apart from a bad one, is a genuine and sincere interest in making sure all of my client's concerns are addressed and ensuring that my clients feel as though they were thoroughly examined and were given sound medical advice, especially if an injured worker is facing surgical intervention.

Third, I will recommend an IME when an injured worker has an unusual condition such as Complex Regional Pain Syndrome (formerly known as Reflex Sypmathetic Dystrophy), and an expert in treating that particular condition is required for a diagnosis or treatment plan. This infuriates the insurance industry because of the cost associated with IME's involving very difficult atypical cases, but every workers' compensation lawyer should be willing to try to provide the very best care he or she can for their clients. Period!   

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