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Temporary Total Disability - Permanent Impairment -
Permanent Disability

The following explanation of terms and the definitions that we use in my clinic for completing requests and reports for profession opinions. Its inclusion is not meant to present something new to the receiver but rather to provide the basis on which requests for opinions are calculated in this health care facility.

Temporary Total Disability - This is a condition based on the docotor's examinations and the evaluation of the patient's functional assessment. Hopefully, this level of decreased function is only for a short period of time while the patient has an opportunity to heal. The patient may be totally disabiled temporarily from his particular job but may be able to return to work in a modified work program that would not slow down the healing process of his injury.

Permanent Impairment - This is a purely medical condition. Permanent Impairment is any anatomic or functional abnormality or loss after Maximal Medical Rehabilitation has been achieved, which abnormality or loss the physician considers stable or nonprogressive at the time of the evaluation. It is always a basic consideration in the evaluation of permanent disability.

Permanent Disability - This is not a purely medical condition. A patient is "permanently disabled" or "under a permanent disability" when his actual or presumed ability to engage in gainful activity is reduced or absent because of "impairment" which, in turn, may or may not be combined with other factors. A permanent condition is found if no fundamental or marked change can be expected in the future.

Evaluating (rating) of Permanent Impairment - This is a function that physicians alone are expected to perform. It is an appraisal of the nature and extent of the patient's illness or injury as it affects his personal efficiency in one or more of the activities of daily living. These activities are self-care, communication, normal living postures, ambulation, elevation, traveling and non-specialized hand activities.

Evaluation (rating) of Permanent Disability - In the last analysis, this is an administrative and not solely a medical responsibility and function. Evaluation of permanent disability is an appraisal of the patients present and future abilities to engage in gainful activity as it is affected by such diverse factors as age, sex, education, economic and social environment, in addition to the definite medical factor: permanent impairment. (it is the patient's ability to seek and be gainfully employed.) Based on this understanding, permanent disabily could easily be a higher percentage than the calculated permanent impairment considering the other diverse factors.

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