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How do they calculate loss of use for on the leg?
Anonymous3 views3 answers
My primary Dr. gave me a 37.5 % loss of use to the leg and the IME Dr. gave me a 15% loss of use to the leg.
On the IME report during his physical examination he said I lack 10 degrees of full extension and flexes to 110 degrees.
Under the conclusion portion of his report for schedule loss of use, he stated partial meniscectomy warrants 7.5% and chondromalacia of the patella at 7.5% for a total of 15%
My question is according to the diagrams showing loss of use percents for flexion and extension it shows the percents to be 20% for 110 degree flexion and 7.5-10% for 10 degree exstension.
Wouldn't this total at the least 27.5% ????? also if this is correct
Does the percents he allowed in his conclusion get added into the 27.5%?? should the total be 42.5 %
Ron
NY state
Loss of use of any body part is most frequently measured by the American Medical Association's Guides to the Evaluation of Permanent Impairment. The guides are used in most but not all states particularly in workers compensation claims. Standardized methodology is used in a clinical setting to evaluate the types of observation you have referred to in the question. The observations are used to calculate a final permanent impairment evaluation number.
The issue is that any time documentation of observation is required, there is room for subjectivity. While the guides and the "standardized approach" are claimed to be "transparent" and "reproducable", your experience of the insurance doctor coming up with a low number and the treating physician identifying a higher evaluation is extremely common.
A common way to expose the flaws in the insurance doctor's "methodology" is in a deposition. Workers compensation and personal injury attorneys who have done this before can tell you that the insurance doctor's thinking often breaks down under closer review.
So, you will only be able to receive a fair shake by retaining an experienced attorney in your jurisdiction.
This question should be best answered by a workers' compensation specialist. If you're represented already, discuss these issues with your lawyer. If not represented, I'd suggest getting a lawyer in this area.
