Ratings are important to Maryland workers compensation cases. It could be the difference between lifetime medical coverage and substantial compensation, or nothing!
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What is a rating?
For a quick explanation see the definition of a rating. A rating, as referred to in workers comp, is an evaluation and accompanying report by a qualified physician. The evaluations are performed for the purposes of determining if the injured worker has sustained any permanent physical problems because of the workplace accident. The physician will meet with the worker and observe, test, and listen to issues that the worker has with the injured body part. He or she will then draft a report containing all of the above information along with medical history. Most importantly, the physician will include a rating percentage which will help the workers comp attorney determine the expected value of the case. In Maryland, the physician is required to use the 4th Edition of the American Medical Associations Guide to Permanent Impairment. There is however, more to evaluating a claim for settlement value than just this rating number.
Why get rated?
It is important to be evaluated for a rating for a number of reasons including obtaining the compensation to which every injured Maryland worker is entitled under Maryland law. Unfortunately, the injured employee has no way to force settlement out of the workers compensation insurer. A Maryland workers compensation attorney can force compensation from the workers comp insurer by filing for a hearing before the workers comp commission. In Order to file for the hearing and be successful in obtaining a favorable award the injured worker will need to have a impairment rating. If there is no impairment rating then the workers comp commissioner will likely not have enough evidence to award compensation.
The rating will (presumably) get the injured Maryland worker an impairment award. The impairment award is necessary to solidify any chance of the employee obtaining medical treatment for life. Very seldom is medical coverage provided for any extended period of time when the claimant did not receive an impairment award by the Maryland Workers Compensation Commission.
When do I get rated?
Often, injured workers get frustrated with their Maryland workers comp attorney because it is taking so long to receive compensation or a settlement. It is a sediment any qualified workers comp attorney knows all too well. With workers comp settlements it is most often necessary to obtain a rating before agreeing to any type of compensation. This is because the rating helps provide a starting point for the attorney to analyze for just compensation amount.
Unfortunately for the injured worker, an accurate rating can only be performed when the injured worker is discharged from medical care. This means that the injured worker must be done with treatment. If medical treatment carries on for 5 years, a rating will likely not be performed for 5 years. What is the reason an injured worker must wait until treatment is finished to be rated? Permanency compensation to the injured worker is only an entitlement if the injured worker has a permanent impairment. To determine if an impairment is permanent the injured worker can not be seeking treatment to make them better. They must be at Maximum Medical Improvement (MMI).
Who will perform my rating?
An injured Maryland worker must be very careful choosing who performs the rating. Choosing a qualified physician is as important to the process as is choosing a qualified Maryland workers compensation attorney. The physician must first know how to use the 4th Ed. AMA Guide to Permanent Impairment. Having a solid grasp on this book is necessary and failure to use or even completely understand the resource can completely dismantle the workers future rights. Also, there are certain circumstances an internal medicine physician is qualified to perform the rating while other times it may be best to use an orthopedic surgeon, neurologist, neuropsychologist, or psychologist.
One further consideration when choosing a doctor to perform a rating is whether that doctor ordinarily performs favorable ratings to the insurance company or the injured worker. There are physicians that are regularly used by claimants attorneys and there are physicians that are regularly used by insurance companies. Do not trust the work comp insurance adjuster to point you in the correct direction.