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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