What is an Impairment Rating Anyway?

Todd M. Narson, DC, DACBSP

If you have suffered an injury caused by someone else (such as a motor vehicle accident, slip & fall or some type of product or workmanship failure) and has hired an attorney to represent you, than you may require an impairment rating at the conclusion of your medical treatment.

Physicians do not learn how to calculate impairment ratings in school. It doesn’t matter if your doctor is an MD, DO, DC or Dentist, impairment rating is just not taught in school or during internship or residency programs. There are post graduate classes that teach doctors and lawyers how to rate impairment, however the majority simply render a guess.

The problem with guessing is the high rate of inaccuracy.  An inaccurate impairment rating is detrimental to either side of a law suit. An erroneously high impairment rating can cost whomever is on the hook for costs to pay excessive amounts or an erroneously low impairment could cost the injured person from much needed compensation to take care of mounting medical bills, future medical procedures and possibly help manage life with the loss of their ability to earn an income.

So what exactly is an impairment rating? Most physicians probably couldn’t tell you the difference between an impairment rating and a disability rating.  However simply put, an impairment rating is a number that represents a percentage of the body that no longer functions the way it is designed to work.  It represents a portion of your body that doesn’t work anymore.  A portion of the body is physically impaired.

An impairment rating however actually means a whole lot more.  Yes an impairment rating is a number but let’s put that number in context with what it represents to the person suffering from the particular injury that number.

Imagine for a moment that a concert pianist and a professional soccer player were in a taxi traveling home from work. At the same moment another car crashed into their respective taxis resulting in the index finger from their right hand being severed completely.  Complete amputation of the index finger of the right hand at the base knuckle (aka: metacarpal-phalangeal joint, MCP).

According to the 6th Edition of the AMA Guides to the Evaluation of Permanent Impairment, a complete amputation of the index finger is a 100% impairment of that digit. This converts to a 20% impairment of the hand, 18% impairment of the upper extremity and an 11% of the whole person.

So, what does an 11% whole person impairment mean to you as a non-injured person? Probably not much. Now, let’s put this in context with our two taxi-cab passengers.  We have a professional soccer player and a concert pianist both with the same exact injury and both with the exact same impairment rating of 11% whole person. Since a professional soccer player essentially gets penalized if the ball touches his hand and the index finger isn’t critical to inbounding the ball, the resulting disability to his career as a professional soccer player goes almost as if nothing happened. However the concert pianists career is ended.

It’s not only important for a physician to take in all medical facts to calculate an accurate impairment percentage, but once the impairment rating is calculated, the physician must take a step back and see how the impairment rating relates to the patient’s functionality in life. In other words, the impairment is the percent of body function loss whereas the disability is how the impairment relates to a persons employability and how they are able to perform their various activities of daily living.

Are you (or is your patient) the professional soccer player –or- the concert pianist? Same injury with drastically different impacts on their professional careers.

If you have a patient/client/insured and you need to know if the impairment ratings in the associated doctor’s reports are accurate, I am happy to consult with you. Email me directly at


When you have damaged your vehicle, you are taking it to a professional. And, when you are sick, you are going to your primary care physician. But, why don’t you want to find an accident doctor after a car accident?

Something that so many car accident victims are doing wrong is that they don’t go for a full check-up after a car accident. And, this can be the one wrong thing to do. You don’t know if you might have been injured if you don’t go for a full checkup from the right type of doctor. And, you should not wait until you are in a car accident before you are getting more information about accidents and getting the right treatment. This is why you need to make sure that you are going to remember all this mentioned information to ensure that you know the importance of going to an accident doctor after any car accidents.

Injuries that you can sustain after a car accident

Depending on the seriousness of the car accident, you can have sustained different injuries from a car accident. If you are seriously injured, you need to go to the ER ASAP.

However, if you are walking away from the accident, it doesn’t really mean that you aren’t injured. There are a lot of people that don’t seek medical attention after a car accident because they feel that they weren’t injured seriously enough.

One thing that you need to remember, that any type of injury after a car accident can become serious. These are some of the minor injuries that you might have sustained during a car accident that also need medical attention:

    • Back and neck pain
    • Headaches and dizziness
    • Whiplash
    • Shoulder pain
    • Strains, sprains, and spasms
  • Depression and mood swings

You will see that these injuries aren’t serious, but you still need to be checked out by a car accident doctor to ensure that the injuries are really not that serious.

Delayed injuries. This can cause serious injuries if left untreated

Is this something that is real, or just an excuse to get attention after a car accident or to get compensation from the person that has caused the accident? This is a question that many people are asking. Because delayed injuries don’t really make sense to them.

The thing about delayed injuries is because you can’t really see it. It can be anything from whiplash to internal bleeding, or even a skull fracture. You don’t feel the injury and pain directly after the accident, but a day or two later, you realize that there is something seriously wrong with you. And, then most people are going to see a doctor for to get diagnosed.

Something to consider is that the moment that you realize that you have a delayed injury, it might already be too late to treat it successfully. For example, head injuries that are left a couple of days before getting it treated can lead to permanent damage. Serious delayed injuries may become life-threatening.

This is why you should make sure that you are going to see a doctor right after the accident. Even, if it seems that you don’t have any injuries. If a delayed injury is treated before the symptoms are showing, the possibility of recovering is much higher.

Why should you see a doctor after a car accident?

Besides delayed injuries, there are many other reasons why you should find a doctor after a car accident. Reasons that you might not realize because you weren’t in a car accident before.

The moment that you are in a car accident, shock and trauma set in.  This can cause your body to produce more adrenaline. And, this is causing you to feel fine and not injured. But, the moment that the shock wears off and the adrenaline is getting back to normal, pain can start setting in.

And, this might be a serious injury that can become life-threatening if you don’t see a doctor right away. Shock is also something that might need to be treated, to ensure that you are recovering mentally as well. And, then a doctor will be able to give you a full check up to see if you have any other injuries as well.

The other reason why you should see a doctor as soon as possible is for claiming. If you are getting a delayed injury, you need to be able to claim from this injury. And, if you don’t go to the right accident doctor, it may become really hard to prove that you were injured during the car accident.

The right type of doctor that you should see

Now, you might be wondering what type of doctor you should see. There are rumors that going to see your primary care physician isn’t an option to get the right treatment and to get the proper documentation for your personal injury.

The one thing that you should remember is that you should seek the medical attention from an accident doctor. This is a doctor that has all the right experience and knowledge of car accident injuries. They are also used to fill in the claim forms and even to testify in court about your injuries.

Yes, you can go to your primary care physician, but this isn’t recommended. They may want you to pay out of pocket. Time can be important when you are injured and needs immediate medical attention. This is why you should rather consider going to an accident doctor right from the start. Then you have the reassurance that you are in the best possible care.

Accident doctor or Primary Care Physician

You have normally two choices of medical professionals that you can see after a car accident. The one is the accident doctor and the other option is your PC.

Many are wondering which one is the best one for your injuries and to get your injury claimed approved. It doesn’t really matter who you are seeing, but there are a couple of things that you should consider before you can make your final decision.

    • 1st-your PCP does not treat soft tissue injuries.
    • 2nd-Your primary care physician may not know how to document a personal injury.
    • 3rd-They want to be paid up front, out of your pocket
  • 4th-They will not work on a medical or attorneys lien

What will happen when you don’t seek medical attention after a car accident?

What is the worst thing that can happen to you when you don’t seek medical attention after a car accident? And, why is it necessary to see a doctor if the car isn’t damaged that much? A delayed injury can become serious if it is left untreated. Especially when it comes to internal bleeding, head injuries and neck and back injuries that are left untreated.

The other thing that can happen to you if you don’t get medical attention after a car accident, is that you will not be able to prove that you have sustained injuries after a car accident and that you are able to get compensation for your sustained injuries.

Finding the right accident doctor

Finding the right accident doctor isn’t as hard as what you might think. And, it is recommended that you always have the name and number of an accident doctor in your area at hand. Even if you have never been in an accident before.

You can ask your primary physician for the names and numbers of accident doctors in the area. You can ask an emergency room or you can ask a personal injury attorney. They are all in contact with accident doctors and they can give you the names that have the right experience.

Payment options when you are seeing an accident doctor

One of the reasons why many people don’t go to an accident doctor is because they are worried about how to pay these doctors. Not everyone has health insurance or cash to pay for an accident doctor. Or, this is what most people might think.

However, there are many other ways that you can pay the accident doctor after your visit and treatments. Options that you can choose that are best for you. With knowing all these information about the different options that you have, you will not worry about paying the doctor to see them for an injury that might not be serious. These are some of the different ways that you can pay the accident doctor for the treatment you received.

Med Pay

Med pay or medical payment is something you add to your existing auto insurance. It will cover whatever dollar amount you set. It pays medical expenses for you and anyone in your car no matter who was at fault


PIP or personal injury protection is a benefit that you can get from your car insurance policy. However, at the moment this is just something that is available in some states.

PIP is almost the same thing as a health insurance plan. They are paying for your injuries that you have sustained if you are seeing the right medical doctor. With this option, you will not need to worry about payments. The good news is this pays for your medical care for you and anyone in your car no matter who was at fault.


LOP stands for a letter of protection. This is a letter that you can give your accident doctor that is sent from your attorney to say that you will pay the medical bills when your case is over and you have received compensation for your injuries.

This is giving the doctor reassurance that they will get paid and that they can still treat you so that you can recover from your injuries. The doctor normally doesn’t ask higher fees or adding interest to the money you own him.

Medical Lien

A Medical Lien is a document you sign with the doctor who is treating you. You agree to pay him when your personal injury case settles.

Attorney’s Lien

This is something an accident attorney will sign and send to the doctor. The personal injury attorney agrees to pay the doctor when your case settles.

 Conclusion: Going to an accident doctor is essential after an accident

Accidents do happen, and you need to make sure that you know the importance of going to see a doctor after a car accident. This is because you might have injuries that you don’t know about. Delayed injuries are real and it can leave you with permanent injuries, just because you didn’t get treatment early enough.

It is important to make sure that you know everything about seeking assistance after a car accident. This is because you need to make sure that you are not injured at all. Too many people don’t realize the importance of getting a full check up by an experienced accident doctor after a car accident. Even if the car accident was minor and there wasn’t any damage to the vehicles. Our heads, neck, and back are delicate and can get injured easily. Even if the car isn’t damaged. The only way to rule out any serious injuries is to make an appointment with an accident doctor near you. 

Should I get an attorney for auto accidents?

Yes! Hiring a lawyer for a car accident is a great decision when you are not at fault and feeling pain or suffering from the accident. With a lawyer by your side, you will have a huge advantage over someone who doesn’t have a personal injury attorney and wants to file for claims and losses. The huge advantage comes from the years of experience and knowledge of the law that the lawyer and firm provide. If you hire a lawyer the chances of you recuperating your losses and getting your life back in order are maximized.

Can I fire my auto accident lawyer?

Yes, you can fire your auto accident lawyer at any time and for any reason. However, this doesn’t necessarily mean you should do so without considering a few things beforehand.

  1. You should hire a new car accident lawyer before you fire your current lawyer and write the court a letter with a notice of a change in who is representing your case.
  2. Make sure that you also have written proof of a letter sent to the attorney you are firing that states they will no longer be representing your case.
  3. Make sure that it is worth your time to go through the process of firing your current attorney and hiring a new one. These processes can take a long time and are not worth the hassle for most cases unless there is a significant amount of settlement potential you think you could achieve with the new attorney.
  4. Most personal injury lawyers do not charge fees (unless they win), however, if they do, you will have to pay any outstanding balances on your account with that attorney.

At the end of the day, there are various reasons you would want to fire your car accident lawyer, however it is important to make sure that the decision is worth your time and money, if not, try to stick through with your current lawyer and make it work!

There are three steps a driver who is involved in an accident must take.

  1. In Florida, you are legally required to help anyone you believe has been injured or hurt from the accident.
  2. You must call the police or the Florida highway safety patrol if you believe there is over $500 worth of damages from the accident or if someone has been injured.
  3. Try your best to move your car out of the way from traffic. If you are unable to move your car for any reason you should call a tow truck to do it for you.

Please remember, these are only steps required by Florida Law. There are several safety precautions and steps to take after the accident that you should do in most cases. Some of these steps involve:

  1. Hire a car accident lawyer if you believe there was a form of negligence from the other driver.
  2. Make sure there was accidents report written so that you can make claims on your insurance.
  3. Record your own information and notes about the crash so you don’t forget any details later.
  4. Gather witnesses for the accident so it is easier to prove who is at fault.

Unfortunately, most people will be involved in a car accident at least once throughout their lifetime. It is important to know these steps beforehand to minimize the stressful conditions of a car accident.

What is an auto accident?

Although this may seem like a very simple question, many people will only answer it partially right. A car accident is the event in which a car strikes another car, pedestrian, animal or any stationary object. Most people will forget that car accident don’t always have to involve other cars, therefore answering this question incorrectly.

How to negotiate auto accident settlements?

Negotiating car accident settlements are not much different than negotiating anything else. However, there are a few things to make note of that can put you in an advantageous position against the insurance companies.

  1. You will never receive more than what you ask for, so always start with a very high ask, it doesn’t hurt.
  2. Make sure you added up all the bills that came from the car accident, you will want to recover at least this amount. Remember; never ask for just the amount that you added up, you are likely to get less than whatever you ask for. This would result in a loss, which should be the case if you weren’t at fault in the accident.
  3. Know exactly what your insurance policy covers. This works both ways, as there is no point in fighting for something your insurance doesn’t cover, however, it could also lead you to find damages that you didn’t know you could recover.
  4. Kindness always works better than angriness in negotiations. Be nice to whomever you are negotiating with and the process wont be as stressful or challenging.
  5. The Insurance Company will lowball you, make sure you don’t lose hope in your numbers and keep fighting for what you deserve. The majority of negotiations will be resolved with a number in the middle of your highest ask and their minimum bid.
  6. Although it is possible to negotiate a car accident settlement for yourself, it is much more effective to do so with an experienced car accident attorney by your side. Remember, car accident law firms have experience and are familiar with the Florida Law, therefore maximizing the potential settlement amount for you.

Does Medicare pay for auto accident injuries?

Yes, generally, Medicare will cover any medical costs that you incur form the car accident after the $10,000 from your PIP insurance is exhausted. Additionally, Medicare will likely cover any medical bills that your general auto liability insurance missed.

Lets Examine what Medicare part A and B will cover for car accident medical bills:

  1. Inpatient Hospital Care
  2. Skilled Nursing Facility
  3. Hospice
  4. Lab Tests
  5. Surgery
  6. Home Health care
  7. Outpatient Care
  8. Preventive Services
  9. Ambulance Services
  10. Durable Medical Equipment

The important thing to remember about Medicare regarding car accidents is that it only kicks in once you fully exhaust your $10,000 in PIP coverage.

DLE Lawyers are happy to introduce you

In this post you will learn about common injuries that come from vehicular accidents. Feel free to comment with any questions.

In the hustle and bustle of today’s day and age, it seems like accidents are inevitable.

Whether it’s not watching your step on a crooked sidewalk or checking your phone at the wrong moment behind the wheel, accidents are part of human nature and, unfortunately, you can’t really plan for them.

However, you can take preventative measures and you can be educated on what injuries you are likely to suffer from should you be involved in a particular accident.

At Car Wreck Doctor, knowledge is without a doubt power. Understanding various accidents and the injuries that you will typically see as a result of these accidents will help you stay focused and eliminate fear of “the unknown.”

And from that point forward, we can point you in the right direction for medical care and legal protection.

Vehicular Accidents

Drivers in the United States collectively spend more than 84 billion hours driving a year. That is a significant amount of driving and a large margin of error.

Especially with the rise of texting and driving, car accidents don’t seem to be disappearing anytime soon.

So what are some of the most common injuries involving motor vehicles?

  1. Whiplash

Whiplash injuries can be very dangerous and go hidden without symptoms for days or even weeks.

When your car is rear-ended, even at a low velocity, your neck will jolt forward and then back without any restraint. This hyperextension can cause serious soreness and lead to neck pain, back pain, and headaches.

  1. Sprains and Strains

Another common injury with car accidents is sprains and strains.

Similar to whiplash, the force of being struck by another driver causes your body to involuntarily react and overextend in awkward and unprepared motions.

This type of overextension can lead to ligament damage in joints. In affected areas, you will most likely experience soreness, stiffness, and overall discomfort.

Slip and Fall Injuries

It may seem silly to worry about falling and injuring yourself, but there are hundreds of ways this accident can creep up on you.

For instance, a Slip and Fall injury can occur from:

    • Improperly labeled slick areas around/within businesses
    • Misjudging steps
    • Uneven sidewalks and flooring
    • Texting and walking
    • Eating/drinking and walking
  • And more
  1. Spinal Cord Injuries

When an individual slips and falls, it is most common for them to fall on their back. Therefore, this accident typically leads to spinal cord injuries.

Spinal cord injuries can range from minimal injuries such as bruising and soreness or paralysis should the spinal cord actually be severed.

While slipping and falling can be comedic on our culture, it is absolutely no laughing matter should a serious spinal cord injury be suffered.

  1. Cuts, Abrasions, and Broken Bones

Depending on the type of fall, the surface you’re landing on, and you’re overall health, there are a range of physical injuries that can occur.

If you only manage a few cuts and scrapes, you’re fairly lucky and should make sure to clean and disinfect the open wounds.

For those less fortunate, broken bones can occur which is incredibly painful and can lead to a significant amount of rehabilitation.

Important note: Even though cuts, abrasions, and broken bones can cause searing pain, they could be covering even more severe injuries such as spinal cord injuries and critical concussions.

Diagnosing Your Accident Injuries

We understand, especially regarding auto accidents, all of the stress that accompanies dealing with a damaged vehicle along with trying to find a good car accident lawyer.

But taking care of yourself is more important in the long run.

Individuals tend to put their soreness and discomfort in the back of their mind while dealing with other stressors and that is not healthy by any means.

Don’t assume with any accident injury that you will just naturally feel better in a few days.

When you visit a medical professional, they will do the following:

    • Gather information regarding your accident type, pain symptoms, and previous medical history
    • Perform medical physical exams on affected areas to test severity and check overall physical function
    • If necessary, conduct imaging exams such as X-rays and MRIs
  • Once the diagnosis has finished, your physician will create a specific treatment plan that is best suited for an optimal recovery

Even soft-tissue injuries like whiplash can be treated by a medical professional.

Don’t suffer through another day with that pain, soreness, and discomfort. Put your health first and foremost and visit a medical professional today.

If you want to learn more about car accident injuries, statistics, and doctors in the state of Florida, feel free to check out Car Wreck Doctor in Florida now.

Accidents are random and impossible to plan for, but we can help you every step of the way.

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