By Law Office of Aili Obandja
After an injured worker reaches End Medical Result or Medical End Result, the worker may be evaluated for permanent impairment. End Medical Result or Medical End Result is sometimes referred to as maximum medical improvement, or MMI. For more about that determination and what to do if it is disputed, see last week’s blog, Get Help With a Vermont End Medical Result Dispute.
A permanent impairment evaluation determines whether the compensable injury caused lasting medical loss and, if so, assigns a percentage rating. The evaluation does not decide whether the worker can return to the former job, has permanent work restrictions, or has sustained wage loss. Those are separate issues.
When Does the Evaluation Occur?
Under Vermont Workers’ Compensation Rules 10.1200 and 10.1210, within 45 days after receiving notice or knowledge that the worker has reached End Medical Result, the employer or carrier generally must take steps to determine whether the worker has a permanent impairment from the compensable injury. The injured worker also has the right to seek a permanent impairment rating from the treating physician or another physician of the worker’s choosing. The employer or carrier must promptly notify the worker of that right in writing.
An evaluation may be premature if the worker has not reached End Medical Result for every compensable condition. If additional treatment is reasonably expected to produce significant improvement, the worker’s condition may not yet be sufficiently stable to rate.
What Does the Physician Evaluate?
The physician should identify each accepted work-related condition, review the relevant medical history, perform the necessary examination and measurements, and apply the authorized rating method. Under 21 V.S.A. § 648(b), Vermont uses the Fifth Edition of the AMA Guides to the Evaluation of Permanent Impairment to determine permanent partial impairment as a percentage of the whole person. The statute permits a subsequent edition only if the Commissioner adopts a rule authorizing it.
A complete report should explain:
The compensable conditions evaluated;
Whether the worker has reached End Medical Result;
The examination findings and measurements;
The provisions of the authorized impairment guide used; and
How the physician calculated the final percentage.
What If the Injury Involves Multiple Conditions?
When a compensable injury involves multiple body parts, systems, or conditions, the worker generally must reach End Medical Result for all components before permanent partial disability benefits become due. Separate impairment values generally are combined under the authorized methodology into one whole-person rating rather than simply added together.
Review the Evaluation Carefully
Check whether the report addresses every accepted condition and accurately states the treatment history, examination findings, and rating method. An incomplete or unsupported rating may materially affect permanent partial disability benefits.
Get Help Reviewing a Vermont Permanent Impairment Evaluation
The Law Office of Aili Obandja represents injured workers in Vermont workers’ compensation matters and can review the End Medical Result opinion, accepted conditions, and permanent impairment evaluation. Call 802-556-3582 to discuss your claim and the next steps that may be available.
This blog is for general informational purposes only and is not legal advice. Reading it does not create an attorney-client relationship. Workers’ compensation rights depend on the specific facts, medical evidence, and applicable deadlines. Consult an attorney about your particular situation.
