Injured Workers

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Frequently Asked Questions About Work Injuries answered by the California Division of Workers’ Compensation:

What is an Permanent and Stationary/Impairment/PR-4 exam?: An impairment exam is a special visit with the doctor to tell your whole story of your injury to the insurance carrier. Sometimes this exam report is called an “Permanent and Stationary Report “(P & S), an “Impairment Report” or a “PR-4” report. The visit requires answering some questions about your work injury, and the doctor performing a physical exam and taking special measurements. This exam is important to distribute the future benefits of your claim.

Why isn’t my regular work injury doctor doing this exam?: Your doctor has referred you to an “impairment rating specialist” doctor because this report requires an expert to write your report correctly. Each year we write approximately 1,500 of these reports for injured workers and their insurance carriers. This report must be written using a special book called the “American Medical Association Guides to the Evaluation of Permanent Impairment 5th Edition”.

Does this mean my case will be closed?: When you are sent for an impairment report, your doctor has decided that all useful and reasonable treatment for your problem has been completed. The impairment report is actually used to tell the insurance carrier what type of care you will need in the future to help you feel your best. This section in the report is called “Future Medical Care”. Future Medical Care may include ongoing access to physical therapy, certain medications, or medical procedures like surgery.

What if I still have pain? I am afraid that I cannot return to my job.: The impairment report will tell your employer and insurance carrier about your ability to return to work. This opinion will include what you can and cannot do at work. The report will take into account your pain/symptoms, the physical exam findings, and any tests or studies that have been performed during your care. If the doctor determines you have ongoing work restrictions as a result of your injury, these restrictions will now be called “Permanent Functional Restrictions”.

What if I am unhappy with my impairment report findings or disagree with the doctor? : Workers’ Compensation injuries can be complicated. Your pain and symptoms must be considered along with the findings of your physical exam and any tests performed. If a finding on the exam is unclear or does not make sense to you, consider first talking to your evaluating doctor at the exam. If your questions still remain, it is recommended you then speak with your insurance adjuster, or designated employer representative. Finally, you may consider seeking a second opinion in the “Panel Qualified Medical Examiner” system, sometimes called a “QME”.

What is a QME?: The letters “QME” stand for "Qualified Medical Examiner". To become a QME, the doctor, or health professional, must pass a state written examination to demonstrate competency in the basic rules and regulations of California’s Workers’ Compensation system. Upon completion of this test, the doctor or health professional, is now certified to perform independent evaluations to help injured workers and insurance carries answer questions that may be delaying the claim. Injured workers or their insurance carriers may request a QME exam for purposes of a second opinion. For more information on the QME system you may contact the California Division of Workers’ Compensation (DWC)

Click here to download our Frequently Asked Questions about Permanent and stationary (P&S)/Impairment Report/PR-4 Reports

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