Episode 30: Are Impairment Ratings Necessary on Every Patient?

🔑 Key Takeaways:

1. Impairment Ratings Are Often Dismissed—but Critical.
   Many legal and medical professionals believe impairment ratings aren’t necessary. Dr. Carter argues that they are essential when patients have reached Maximum Medical Improvement (MMI) and still experience functional limitations.

2. What Is an Impairment?
   According to the AMA Guides, impairment is a permanent loss, loss of use, or derangement of any body part, organ system, or function. This must be assessed after treatment has been exhausted and the patient has stabilized.

3. Functional Limitation vs. Disability:

   • Impairment → A medical condition post-MMI (e.g., restricted shoulder mobility).

   • Functional Limitation → How it affects daily activities (e.g., can’t lift objects).

   • Disability → A workplace inability due to functional limitations without available accommodations (e.g., can’t work as a stock clerk if no lift is available).

   • These are often confused and must be evaluated in sequence.

4. Assessment Tools Matter.
   Physicians must use imaging (MRI, X-ray), clinical exams, patient history, and functional questionnaires (e.g., Pain Disability Questionnaire, Loss of Enjoyment, Duties Under Duress) to support the rating.

5. Legal vs. Medical Perspective:
   While legal teams may deprioritize impairment ratings, insurance carriers require medical evidence of permanent changes. It’s the doctor’s role to document and communicate this clearly.

6. Training Is Crucial.
   Physicians should pursue training in trauma care and impairment evaluation to better serve personal injury patients and support legal outcomes.

🩺 Final Thought:

“You can’t talk disability without first establishing impairment. And you can’t assign impairment until the patient hits static Maximum Medical Improvement.”

📩 Call to Action:

If you have questions about impairment ratings, MMI, or documenting personal injury cases:
👉 Email Dr. Carter at [email protected]
👉 Visit www.PISciences.com
👉 Register for our Case Management Webinar:
pisciences.com/alohacasemanagement