Your claim will be ready for closure when your attending physician says that your medical condition is fixed and stable (meaning there is no further curative treatment) and, hopefully, you have returned to work. You may be entitled to a permanent partial disability award (PPD). You will be entitled to a rating of permanent impairment for conditions resulting from your industrial injury or occupational disease. Your attending physician can do the rating or your claims manager may send you for an examination by one or several physicians.
A physician must rate PPD. Your own doctor can provide the rating for your injuries. If your doctor is unwilling to rate, however, the Department or self-insured employer will send you to a one-time examiner — a so-called Independent Medical Exam or IME — for purposes of getting rated. WAC 296-20-2010 (1) provides:
Impairment rating examinations shall be performed only by doctors currently licensed in medicine and surgery (including osteopathic and podiatric) or dentistry, and Department-approved chiropractors subject to RCW 51.32.112. The Department or self-insurer may request the worker’s attending doctor conduct the impairment rating when appropriate. If the attending doctor is unable or unwilling to perform the impairment rating examination, a consultant, at the attending doctor’s request, may conduct a consultation examination and provide an impairment rating based on the findings. The Department or self-insurer can also request an impairment rating examination from an independent medical examination (IME) provider. A chiropractic impairment rating examination may be performed only when the worker has been clinically managed by a chiropractor.
It is important to prepare for an IME. You should know what the IME doctors know; what tests they use to try to prove that you are not injured; things they will do to try to minimize your limitations. Some IME doctors make their living from examining injured workers.
If you are sent for such a special examination (by so-called independent examiners), your attending physician should have the opportunity to review and comment on the report.
The rating of impairment is based on the area of your body that was injured. For arms and hands, feet and legs, vision or hearing loss, a doctor will use the AMA Guides to Permanent Impairment, Fifth Edition, to determine the percentage of amputation value of your finger, hand, arm, foot, leg, or percentage of your loss of vision or hearing. These are called specified disabilities. The doctor will determine your permanent partial disability by examination and will base his or her rating on criteria such as loss of range of motion, muscle wasting and weakness, and nerve damage, or objective testing of your hearing or vision loss. Multiply the resulting percentage of loss based on the AMA Guides by the value of your finger, hand, arm, foot, leg, etc., as set by law, to determine the permanent partial disability award.
For injuries involving your neck, mid or low back, mental health impairments, and other areas not listed above, also called unspecified disabilities, the rating doctor will use the Categories of Permanent Impairments. Each Category is a percentage of total bodily impairment, the value of your entire body — an amount set by law, and based on criteria determined by law.
If you feel that your claim closed prematurely or that the rating of your disability is low, you will have only 60 days from the date you receive the Department’s closing order to protest or appeal the closure of your claim.