• Don't look for large numbers! Bigger does not necessarily mean better. A patient who is 100% impaired is dead -- no bodily functions! Patients with large impairments over 50% are candidates for wheelchairs, canes, etc. 100% disability indicates that the patient cannot work. Sometimes a small impairment such as 2% or 3% can produce a 100% disability. This of course depends on the patient's occupation. Give the patient his just do; however keep the rating within reason. Make sure the rating is based on scientific, reproducible findings, and back up those findings with as much objective testing and clinical studies as possible.

  • Look for the obvious. Don't cloud the rating with insignificant findings. If the rating involves the low back and the patient has a pre-existing or current elbow problem that is not related to the accident, do not include the elbow in the rating. Pre-existing problems may be included when the injury involves the same or an anatomically related area. When a pre-existing condition has been considered, it should be addressed as a pre-existing condition and separated (subtracted) from the final rating (this is referred to as apportionment).

  • The patient must be at maximum medical improvement (MMI) for a rating to be considered permanent. A rating can be assigned at anytime during the course of treatment for whatever reason, however it cannot be considered permanent if the patient is not in a state or stable state. If a rating is done prior to MMI, it should be recognized as such, and the report should reflect that it may be amended at a future date. It is not a recommended procedure to do impairment rating exams during the course of active treatment.

  • The evaluator must use common sense. If an injury involves a hand, and the case is only concerned with that injury, the physician should only rate the hand. The Guides state that the impairment should be confined to the accident or injury that has occurred and should not concern itself with prior injuries or conditions that were not related to the current accident or injury.

  • When reporting the rating in the narrative, make sure all of the mathematical calculations are shown -- ImpairMaster does this for you. A concise and detailed narrative report may help bring a case to a successful conclusion and settlement. This may help avoid depositions and courtroom testimony by the physician. It will certainly help improve the doctor's image with the legal profession, and can surely help a patient prevail in his quest for legal damages.

  • The final step in the rating procedure is to look at the permanent impairment rating assigned to the patient; step back and look at the patient; then determine whether they are compatible. Even an accurate and honestly performed rating may not be accepted by a judge or jury if it does not seem to logically correlate with the patient's outward appearance and symptoms.