Your impairment rating can have a big impact on how much money you walk away with in your workers’ compensation case. But that number isn’t decided at one final appointment. Your medical records are building the case for your rating from the very beginning. Let's break it all down so that you're prepared and are able to get the most out of your workers' compensation case.
The fight over your impairment rating starts from day one, not at your final permanency exam. Your medical records are building the evidence for that rating throughout your case.
Once you reach maximum medical improvement (MMI), your doctor and the insurance company’s IME doctor may give different ratings. If they disagree, a judge may decide which opinion is more convincing based on your medical records, the doctors’ testimony, and your attorneys’ arguments.
That’s why your records need to show the full picture. Make sure every injury and symptom is documented, including problems that develop later. Tell your doctor how the injury affects your daily life, avoid unnecessary gaps in treatment, and review your reports for mistakes. Keeping a simple journal of your symptoms and limitations can also help you accurately remember good days, bad days, and changes over time.
By the time you reach your permanency exam, you want the record to already show what you’ve been dealing with all along.
Before your impairment rating exam, focus on building a medical record that accurately shows your injury and how it affects you.
Make sure every injury and symptom is documented, including problems that develop later. Tell your doctor about your real-life limitations—even the uncomfortable or embarrassing ones—and consider keeping a journal of your symptoms, good and bad days, and what you can and can’t do.
You should also read your medical reports and correct mistakes early. Keep up with your appointments and treatment so there aren’t big unexplained gaps in your records. And be upfront about any previous injuries or accidents. The insurance company may find them anyway, and disclosing them early gives your lawyer a chance to address them instead of letting them become a credibility issue later.
Be polite during the IME, but be careful about automatically saying you’re “fine.” Describe how you’re doing overall, including your average, good, and bad days—not just how you feel during those few minutes in the exam room.
Be specific and honest about what you can and can’t do. During range-of-motion testing, give full effort. Don’t exaggerate your limitations, but don’t tough it out and hide pain either.
As soon as you leave, write down what happened: how long the exam lasted, what tests were performed, what paperwork you completed, and whether the doctor actually measured your range of motion with a device like a goniometer. If the IME report later says something different, those notes can help your lawyer identify and challenge inconsistencies.
A low rating from the insurance company’s doctor doesn’t mean the fight is over. When you get the IME report, compare it line by line with the notes you took after the exam.
Look for tests the doctor says they performed but didn’t, things you said that were recorded incorrectly, or other inconsistencies. Mark them directly on a copy of the report and give it to your lawyer.
Your attorney can use those problems when questioning the IME doctor under oath. Every weakness in that report can give the judge another reason to trust your treating doctor’s findings instead.
For non-schedule injuries like the head, neck, and back, your physical impairment isn’t the only factor. Your education, work history, skills, and ability to find future work can also affect your loss of wage-earning capacity and ultimately your permanent disability award.
If you have questions about your impairment rating or your workers’ compensation case in general, feel free to give me, Rex Zachfosky, a call. I’m happy to talk through what’s going on and help you understand your options.
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