Impairment Rating In Texas Workers’ Comp Claims and How it Works

An impairment rating in Texas, as defined by statute, means the percentage of permanent impairment of the whole body resulting from a compensable injury.  It is a measurement of the damage to your body resulting from your work injury. According to Texas workers’ compensation law, impairment is any anatomic or functional abnormality or loss existing after maximum medical improvement.  An impairment rating (or IR) is expressed as a percentage of loss.  So, you might see a doctor issue a report showing that you have a 5% IR.

How Is An Impairment Rating In Texas Assigned?

You are not supposed to get an impairment rating in Texas until you reach maximum medical improvement.  When you reach MMI, you no longer have any expectation of further recovery.  So, at that point, the permanent damage to your body resulting from the injury can be determined.

A doctor or a chiropractor has to assign your impairment rating in Texas.  The adjuster can’t do that.  The doctor who assigns your impairment rating has to have special training to do this.  The Division of Workers’ Compensation requires them to pass a test and be qualified to issue an IR.  One of the things we always check when we review an IR is whether the doctor has the authority to perform that exam.

When doctors assign an impairment rating, they must use the AMA Guides To The Evaluation Of Permanent Impairment, 4^th Edition.  If they use any other book or method to determine the impairment rating, then it is not valid.  The only way to properly use these guides to issue an impairment rating is to do a thorough exam of the patient.  If the doctor did not examine you, then you may need to dispute your impairment rating.

What Does An Impairment Rating Mean In Texas?

First, the impairment rating is a measurement of the permanent damage to your body caused by your work injury.  It is supposed to be done at the end of your medical treatment.  It is the point in your case when any temporary income benefits you are receiving for lost wages will end.  You will be eligible for impairment income benefits.  Impairment income benefits are paid based on your impairment rating in Texas.  You will get 3 weeks of benefits for every percentage of impairment.  So, if you get a 5% impairment rating, you will get 15 weeks of impairment income benefits.

You will usually not get any more money from your workers’ comp claim once impairment income benefits have been paid out.  You can receive additional benefits if your impairment rating is 15% or higher, or you qualify for lifetime income benefits. Severe injuries like cauda equina syndrome or spinal cord impairment are the types of injuries that can warrant these higher impairment ratings.

Final Thoughts

If you disagree with your impairment rating, you may need to file a dispute.  There is a deadline to get this done.  Make sure you consult with a Texas workers’ comp attorney immediately upon receiving your impairment rating to maximize your strategic options.  You may also want to discuss whether you qualify for lifetime income benefits or social security disability benefits.