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 Miamibeachdoc@yahoo.com