knee surgery impairment rating

How do Impairment Ratings get Assigned After Knee Surgery?

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If you suffer a serious workers’ compensation knee injury, your doctor may recommend knee surgery.  Even after you have knee surgery, you may still have some permanent limitations as a result of your injury.

In Georgia and many other states, workers’ compensation pays you some benefits when you have a permanent impairment due to your injury. Unfortunately, there is no compensation for pain and suffering in Georgia so your impairment rating will be the only compensation for the permanency of your injuries. An impairment rating is assigned when an injured worker reaches maximum medical improvement or MMI.

The benefits for permanent disability are called permanent partial disability benefits (PPD) and are based upon an impairment rating that is assigned by your authorized treating physician. The impairment rating will be associated with one or more parts of the body and will range between 0 percent and 100 percent.  These PPD benefits are paid in addition to any weekly wage loss benefits that the injured worker may receive while he or she is out of work due to a work-related injury.  However, the PPD benefits are not commenced until wage loss benefits stop.

Georgia law sets specific rules about how physicians calculate impairment ratings. The law requires the physician to use the 5th Edition of the AMA Guidelines, which is a book published by the America Medical Association.  The book assigns impairment ratings for specific injuries or diseases. For a knee injury, the doctor would use Chapter 17 which deals with the lower extremities.

Following knee surgery, your impairment rating will vary based on the type of surgery, how successful the surgery is, and the injured workers’ limitations following surgery.  There are several factors that the doctor will look at when assigning an impairment rating.

Table 17-33 of the AMA Guidelines provides ratings for several different types of knee injuries.  Some of the knee surgeries listed in the table are:

  • Patellectomy (rating of 7% to the lower extremity for partial and 22% to the lower extremity for total)
  • Meniscectomy (rating ranges from 2% to 22% to the lower extremity and depends on whether the surgery is partial or total and whether it is medial, lateral, or both)
  • Total knee replacement (rating depends on the quality of the result, but ranges from 37% to 75% to the lower extremity)

Not every situation will give rise to an impairment rating.  Most knee surgeries do result in some sort of impairment rating, but some surgeries do not.  If you do not agree with the impairment rating that your doctor assigns, then you can challenge it or get a second opinion regarding the rating. An injured worker can also request a hearing to have a Judge make a determination regarding the proper impairment rating.  Even if you do not have surgery, the doctor may assign an impairment rating, however, it is likely to me be much lower than in a surgical case.

Navigating issues such as impairment ratings in Georgia workers’ compensation cases can be difficult.  If you have questions about your possible impairment rating or your case as a whole, our attorneys are happy to speak with you.