It Is Error When Impairment Ratings Reduced Because Of Pre-Existing Conditions

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An impairment rating is a measurement of the permanent damage done to your body by a work injury.  It is part of a Texas workers’ compensation claim.  These impairment ratings are supposed to take into account all of the damage that you have to live with.  However, the Division and insurance companies want to limit impairment ratings by declaring that your impairment is due to a pre-existing condition.  There’s just one problem with that.  The law says it is error when impairment ratings get reduced because of pre-existing conditions.

How Pre-Existing Conditions Get Blamed For Impairment

Insurance companies typically argue that the work injury healed and the leftover problems are all due to a pre-existing condition.  The Division even issues decisions supporting this type of argument. They will say that the impairment rating is supposed to only include a “compensable” injury.  This means that they are saying it should only include the exact body tissues injured in the new accident, not the surrounding tissues injured in a prior accident.  As if you can figure out which cell in your body was damaged before and which ones are damaged now.

Error When Impairment Ratings Reduced

The Appeals Panel of the Division of Workers’ Compensation considered this question.  In Appeal 022270, the panel looked at how psychological issues made the physical injuries of a worker much worse than they should have been.  The judge in that case had given a low impairment rating, a 0%. He did this because he felt like the higher impairments were caused by the psychological issues the injured worker had.  The judge didn’t think the effects of the pre-existing psychological issues should be taken into account.  But the Appeals Panel reversed that decision.  They said it is error when impairment ratings get reduced due to pre-existing conditions. 

In making that decision, the Appeals Panel noted that the claimant’s pre-existing psychological problems made his injuries more debilitating.  These pre-existing issues resulted in enhanced effects from the compensable injury. It’s just like how a degenerative condition would increase range of motion loss. A compensable injury includes these enhanced effects. It is legally wrong when impairment ratings get reduced because of a pre-existing condition.  If that has happened to you, you must dispute that impairment rating immediately.  There are deadlines to do this.  Talking to a Texas workers’ compensation attorney should be your first step.  And that’s free.

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    1. I agree. That’s the danger in dealing with insurance companies and bureaucracies. Everyone pursuing Texas workers’ comp benefits needs a lawyer.

  8. That’s what the designated doctor did to me. I used an ombudsmen but I dont’ think she didn’t know anything.

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    1. That’s part of what we do for injured workers. I would need to look over your records and the current impairment rating to get you set up with the right doctor to give you a new impairment rating. Who your treating doctor is and the type of injuries you have will affect your options.

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    1. If your knee was injured in your work accident, then you definitely must get an impairment rating for your knee injury. Ombudsmen are not lawyers. They probably didn’t know what to do to help you. A lot of our cases are about establishing the full extent of your injuries and fighting over the impairment rating.

    1. If you still need surgery then you should not be ready for an impairment rating yet. You aren’t supposed to get an impairment rating until you reach maximum medical improvement. If you still need treatment, then you obviously haven’t finished healing yet. We get these types of cases into a hearing as fast as we can. There are deadlines when you need to dispute an impairment rating. Check out this other blog on how to dispute an impairment rating in Texas: https://www.mlflegal.com/2020/07/dispute-impairment-rating-texas/

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