Short Answer: Yes, you can contest an impairment rating.
What is an Impairment Rating?
What is the impairment rating in a Colorado workers’ compensation case? The impairment rating is given as a percentage to those injured workers who have suffered a permanent loss of function of a body part or body system because of the workplace injury. The impairment rating is given by a medical professional to estimate the injured worker’s loss of bodily function. Ultimately, the impairment rating is an important factor used to determine the amount of benefits paid to the injured worker.
How is the Impairment Rating Determined?
The impairment rating is determined only after the injured has reached maximum medical improvement (MMI); in other words, when the injured worker’s condition will not be improved by further medical treatment. Once MMI is reached, the treating doctor will determine the impairment rating based on the American Medical Association’s Guide to the Evaluation of Permanent Impairment.
How to Contest the Impairment Rating?
In a Colorado workers’ compensation case, disputes concerning the MMI or impairment rating are handled by a system called Division Independent Medical Examination (DIME), and is overseen by the Colorado Division of Workers’ Compensation. The most common challenges are workers challenging that their impairment rating was too low or the MMI date is too soon such that the injured needs additional treatment or surgery.
The DIME process is as follows:
- STEP 1: Choosing the DIME doctor:
- A party files a Notice (found at colorado.gov) and proposes three different doctors to perform an independent evaluation.
- Within 30 days, the responding party can choose one of three doctors proposed or propose three other doctors.
- The filing party can then choose one of the three proposed or give notice that there is no agreement on the appointment of the doctor.
- The Division of Workers’ Compensation will provide a panel of three doctors. The filing party will strike one doctor from the panel, the responding party will strike one doctor from the panel, and the remaining doctor will perform the DIME.
- STEP 2: Payment of the DIME:
- The filing party is required to pay for the DIME prior to the DIME being performed.
- STEP 3: DIME opinion issued:
- The DIME doctor performs the examination and issues his/her opinion on the MMI and impairment rating. The opinion is then binding on the parties unless a hearing is requested.
- If a hearing is requested, the challenging party has a duty to overcome the DIME opinion by clear and convincing evidence to an administrative law judge.
Having an attorney who is experienced in the DIME process can be critical to the case. Experienced attorneys know the background and tendencies of the DIME doctors. These DIME doctors have different backgrounds, biases, and practices. Ultimately, the DIME opinion can have a lifelong implication on the benefits the injured will receive.
At Burnham Law, we have a team of lawyers who thoroughly vet DIME doctors. Burnham Law does the due diligence for you to have the best chance of a benefit that coincides with your injury. The attorneys at Burnham Law prepare their clients for the process, questions, and evaluations. This preparation helps our clients understand what is important to the evaluators to properly determine their impairment rating.