Degenerative Disc Disease Of The Lumbar Spine
Most of us will have asymptomatic degenerative disc disease when we reach our 30s. This means that objective diagnostic imaging from Magnetic Resonance Imaging or a CT scan would show lumbar spine damage, though you have no symptoms.
Lumbar spine degenerative disc disease can take many forms:
- Osteoarthritis/Spondylosis: This condition refers to age-related wear and tear of the spinal discs, deterioration of the cartilage protecting the vertebrae, or narrowing of the space between vertebrae
You might see the term lumbar radiculopathy when reviewing your medical records.
Lumbar radiculopathy refers to pain, numbness, and tingling that runs from your back down your legs or feet. It results from compression, injury, or inflammation of a spinal nerve root. The pressure on the nerve root causes the symptoms you are experiencing.
Lumbar spine radiculopathy often accompanies spinal stenosis or a herniated disc.
How Does The Doctor Determine The Disability Rating
The doctor uses a set of guidelines to establish the worker’s level of permanent disability. Many states have adopted the American Medical Association’s Guides to the Evaluation of Permanent Impairment. Other states have modified the AMA’s guidelines or adopted different guidelines altogether.
Using the guidelines, the doctor will come up with the disability rating, usually stated as a percentage. A disability rating is often assigned for certain body partssuch as the arms, legs, hands, feet, eyes, or ears. For example, you might receive a 10% disability of the right arm or a 20% disability of the left foot.
The disability rating may also be stated as a whole person impairment : the percentage of disability to the entire body. WPI ratings are often used for injuries to the back, head, or neck occupational diseases or injuries to internal organs. For example, a back injury might result in a 30% whole person impairment. WPI ratings are also sometimes used when a worker has permanent impairments to multiple body parts.
Dont Back Down: Reach Out For Help
Chronic back pain often persists through multiple treatments and even surgical intervention. Conditions like failed fusion syndrome can leave patients with unmanageable pain. As a result, they may be unable to return to normal work and leisure activities. In addition to seeking further treatment to combat their pain, these patients often need more than just medical help.
Social Security disability benefits provide that additional assistance. But getting approved for disability benefits for back problems can be challenging, largely because of how difficult it is to measure pain.
Thus, consulting an attorney provides you with a much better chance of getting the aid you need. And doing so before you submit your application could save you from suffering through the months-long appeals process.
An experienced disability lawyer will help you navigate the complex Social Security system. Theyll show the SSA that you will not back down from proving that youre entitled to SSDI or SSI benefits.
At The Law Offices of Jeffrey A. Rabin & Associates, we offer free evaluations of patients cases. We have some of the best disability lawyers in the Chicago area on our team. And we can lead you through every step of the application process.
So call us today at 229-0008 and let us fight to get you the help you deserve.
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Who Can Perform An Impairment Rating
The agency for which the impairment rating is being performed determines who can conduct the rating. In some settings, physical therapists provide measurements and reports of impairment ratings for orthopedic and neurologic impairments. In some states, only specialists who have been certified by the American Board of Medical Specialties can provide impairment ratings for workers’ compensation patients. In other states, chiropractors, as well as physicians, are free to provide impairment ratings on any body system .
In the SSA disability program, only acceptable medical sources can provide objective medical evidence to establish a medically determinable impairment, and a licensed physician or a psychologist must sign off on the disability determination. Under SSA rules, chiropractors, naturopaths, acupuncturists, physical therapists, and other lay providers are not considered acceptable medical sources, but they can be used to provide third-party evidence of impairments. Since March 2017, physician assistants and nurse practitioners have been considered acceptable medical sources to provide objective medical evidence to establish an impairment under SSA rules.
Back Pain For Veterans
Spine impairment is one of the leading causes of disability among veterans. Because most of those serving in the military frequently carry and lift heavy loads or engage in quick shifting and running in the line of duty, there is repeated stress and trauma on the joints which affect the health of the spine.
Fortunately, this fact has become more recognized by the VA and those creating policies for the VA. However, it is still important you know how to communicate your pain in order to receive the best possible benefits. Understanding the rules used to determine VA disability for back problems and their ratings will be helpful as you pursue help.
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When Are Disability Ratings Assigned
When you suffer a work injury, your first step is to get medical treatment. Depending on your job and the nature of your injury, your doctor might order you off work or impose work restrictions . During this time, you can receive temporary disability benefits to make up for your lost wages.
When your recovery has plateaued and further treatment isn’t likely to help, your doctor will declare that you’ve reached “maximum medical improvement,” or MMI. This is a crucial stage in your workers’ compensation case: You will now be evaluated for a permanent disability.
List Of Va Secondary Conditions To Back Pain
Many veterans suffer from various service connected back conditions, which can affect your back.
For example, the following codes from 38 CFR, Part 4, Schedule for Rating Disabilities apply:
- Code 5237: Lumbosacral or cervical straina generic label for back pain
- Code 5238: Spinal stenosisthe spinal column narrows and presses on the spinal cord or nerves
- Code 5239: Spondylolisthesis or segmental instabilitywhen a vertebra slips out of position
- Code 5240: Ankylosing spondylitisan arthritic disease that causes the spinal joints to freeze in place
- Code 5241: Spinal fusionthe vertebrae are surgically fused together
- Code 5235: Vertebral fracture or dislocationthe bones of the spine break or slip out of alignment due to a traumatic event like a car accident. Any generic spinal bone injury would be coded here.
These six back conditions can often lead to pinched or damaged nerve roots, which can cause significant pain known as Radiculopathy.
Radiculopathy is commonly rated as a secondary VA disability claim for secondary service connection due to one or more service connected back conditions.
Note that a veteran is eligible to be rated for both a back condition, and Radiculopathy secondary to lower back pain.
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Calculation Of Permanent Partial Disability Indemnity Benefits Using Impairment Ratings
Louisiana law provides a specific schedule of benefits that are due for the total loss of specific body parts.
In the following cases, workers compensation benefits shall be solely for anatomical loss of use or amputation and shall be paid to the injured worker as follows:
Are Va Benefits For Back Pain Permanent
To establish that a disability is permanent, a veteran will need medical records and opinions stating that the disability will be unchanged or worsen during the remainder of their life. Because these conditions are not typically considered to be permanent in nature, VA may schedule re-examinations every few years to determine the severity of the back or neck condition.
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What Are Common Causes Of Work
A single traumatic event can cause back pain. Or your symptoms might develop gradually due to repetitive activity or motion over time.
The distinction is significant because some states workers comp laws do not cover cumulative trauma injuries.
Common acute traumas resulting in back injury include:
- Someone elses negligence or intentional act. For example, a co-worker dropping an item that you are tandem carrying, another driver making a mistake that causes an automobile accident, or your employer failing to provide help in the form of co-workers or safety equipment.
Additional Whole Person Impairment
In addition to the impairment allowable for each category, further impairment is added for the effects of surgery. Spinal surgery with no residual symptoms attract a further whole person impairment of between 1-3%. Spinal surgery with residual symptoms attract an additional whole person impairment of between 2-3%. Second operations can attract between a further 1-2% whole person impairment each.
Disc replacement surgery is the equivalent of a spinal fusion.
The implementation of a spinal cord stimulator or similar device does not attract any additional whole person impairment.
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Individual Unemployability For Back Pain Injury
Veterans who are unable to secure and follow substantially gainful employment as a result of their back pain injury may be eligible for total disability based on individual unemployability . If granted, veterans will be compensated at the 100 percent level even if their combined schedular rating does not come to 100 percent.
Learn What Factors To Consider And How To Negotiate A Fair Workers Compensation Settlement For A Back Injury Resulting In Lower Back Pain Lumbar Radiculopathy And Spinal Stenosis
Are you or a family member one of the more than 1 million American workers who suffer a back injury at work each year?
Then you know that a workplace back injury can cause severe consequences, including:
- Lost wages because of time missed from work
- Reduced income for the remainder of your life
- Job loss and the need to change careers
- Medical bills that result in debt collection proceedings and bankruptcy
- Chronic pain resulting from failed back surgery syndrome
- The need for future medical treatment, including prescription medication and even surgery
- A greater likelihood that you will need Social Security Disability benefits
As if these consequences arent enough, many of you will face aggressive insurance carriers or third-party claim administrators such as Sedgwick, Gallagher Bassett, or Coventry that refuse to accept your claim and pay benefits without litigation and the need for a workers comp hearing.
Fortunately, help is available. And you are in the right place to learn how to get medical treatment and every dollar you deserve for a back injury under workers compensation law.
If you have questions about your legal rights after a work injury or want help negotiating a workers comp back injury settlement, call me: 251-1620 or 810-5614. See why my fellow attorneys and past clients have named me a Top 100 High Stakes Litigator and one of the Best Workers Comp Lawyers for Claimants in America. Im ready to get results for you.
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Impairment Ratings And Permanent Partial Disability Indemnity Benefits In Louisiana Workers Compensation
Permanent partial disability benefits are monetary benefits for the injured employee who is able to perform some work, but has suffered permanent or disfiguring injuries such as amputation , significant scarring, hearing loss, blindness, internal injuries or other catastrophic injuries.
If an injured employee is unable to perform his or her usual or customary occupation but can engage in some other gainful employment for which he or she is suited by education, training, or experience, then this employee is deemed to be partially disabled.
Permanent partial disability benefits are paid as a lump sum payment, according to an amount set under Louisiana law.
Unlike other disability benefits such as temporary total disability benefits and supplemental earnings benefits which compensate an injured worker for wage loss, permanent partial disability benefits compensate an injured employee for loss of use of a body part or for disfigurement.
This is because permanent partial disability benefits are based on impairment or disfigurement not on wage loss, like temporary total disability benefits and supplemental earnings benefits .
How Much Is The Average Settlement For A Back Injury
The amount you may receive in a settlement for a back injury will largely depend on:
- The severity of your injury.
- The complexity of your case.
- The length of time it takes for your injury to stabilise.
- Your age and pre-injury lifestyle.
- The amount of time you need to take off work and your lost earnings.
- Any changes to your ability to work.
- The medical care and support you require.
If you sustain workplace injuries as the result of a motor vehicle accident, you are entitled to claim under the work health and safety WorkCover and TAC schemes respectively, regardless of who is at fault.
You can receive an amount of compensation for an Impairment Benefit Claim which reflects your assessed impairment rating and the relevant compensation associated with that impairment rating in the legislation.
In addition, if you have sustained a serious injury as a result of someone elses negligence, you may also be able to bring a common law claim for damages. Settlement negotiations can occur at various times throughout the resolution process and offers of settlement can be made at any point before or during legal proceedings.
The amount of compensation or damages that may be offered in a settlement will largely depend on the seriousness of your injury. The more serious your injury, the greater your economic and non-economic damages are likely to be.
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Paragraph And Subjectdatetransmittal No
Chapter 2-1300 Impairment Ratings
1 Purpose and Scope. . . . . . . 11-16 17-01
2 Policy . . . . . . . . . . . . 11-16 17-01
3 Definition of Impairment . . . 11-16 17-01
4 General Requirements for
5 How a Claimant Files an
Impairment Claim . . . . . 11-16 17-01
6 Impairment Ratings by the
Employees Choice Physician. 11-16 17-01
7 Impairment Ratings by a CMC. . 11-16 17-01
8 Impairment Ratings for
9 Receipt of the Impairment
Evaluation . . . . . . . . . 11-16 17-01
11 Impairment Award . . . . . . . 11-16 17-01
12 Impairment and Tort Offset/
State Workers Coordination. . 11-16 17-01
13 How to Calculate Increased
Impairment Award with Tort
14 Issuance of a Recommended
15 FAB Development. . . . . . . . 11-16 17-01
16 Additional Filings for
1Not at MMI Letter. . . . . . . 11-16 17-01
2 Not Claiming Impairment
Letter to Physician. . . . . 11-16 17-01
4 Impairment Rating
5 Required Medical Evidence for
Specific Conditions. . . . . 11-16 17-01
6 Breast Impairment Letter . . . 11-16 17-01
3. Definition of Impairment.
4. General Requirements for Impairment Ratings.
a. Covered Employees. The employee is a covered Department of Energy contractor or subcontractor employee, or Radiation Exposure Compensation Act section 5 employee found to have contracted a covered illness through exposure to a toxic substance at a DOE facility or RECA section 5 facility.
b. Claiming Impairment. The employee has to claim impairment in writing.
8. Impairment Ratings for Certain Conditions:
Va C& p Exams For Back Pain
After you file your claim, the VA may decide to conduct a compensation and pension compensation exam on your back or spine if they need more information or medical evidence to support your claim.
C& P exams help VA evaluators determine the severity of your condition and assign a rating for it. Your rating will determine your eligibility for monthly payments and other VA health care benefits, according to the VA.
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What Types Of Back Injuries Cause Permanent Impairment
Workers compensation back injuries can occur many different ways. Some of the common causes of work-related back injuries include:
- Vehicular accidents
- Crush injuries
These types of accidents and others often cause serious back injuries. While back sprains and strains may heal up without permanent impairment, work injuries often can cause herniated discs, lumbar and thoracic fractures, and other spinal injuries.
While not all back injuries cause permanent impairment, spinal injuries often do. When you need surgery as a result of a back injury, you will very likely end up with some form of permanent impairment.
What Is A Disability Rating
A doctor will perform a physical examination and test your ability to function and perform normal daily activities. The exam might involve activities such as testing your range of motion, ability to balance, lifting capacity, and more. The doctor will then use a set of guidelines to calculate your permanent disability rating .
In most states, your workers’ comp treating doctor will perform the evaluation and assign a rating. However, if the insurance company disagrees with the rating, it can request you to undergo an independent medical examination . The IME doctor will perform another evaluation and assign a new rating. It’s not uncommon for these two ratings to conflict, in which case it is up to the workers’ comp judge to decide which rating is appropriate . Or, you and the insurance company might agree to take the average of both ratings in coming up with a settlement agreement.
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