Shoulder injuries are no joke. The shoulder is the most versatile joint in the human body. Shoulder injuries are tough to recover from. Once you’re at MMI, your doctor will give you an impairment rating. In Colorado, impairment ratings are based on the American Guides to the Evaluation of Permanent Impairment, 3rd Ed. Revised. The doctor will send the report to the insurer, and it will say something like “patient has 25% impairment to the upper extremity, which converts to 15% impairment to the whole person.” In all likelihood, the insurer will admit for the 25%.
Why are insurer likely to pay based on the higher rating? Why would the doctor provide the whole person rating and the upper extremity rating?
25% impairment of the upper extremity is worth $21,848 for current dates of injury. 15% whole person impairment for a 35-year-old who earns $75,000 per year is worth $86,538.60. Extremity and whole person rating are calculated based on separate equations. In my experience, insurers never admit that the shoulder injury affects the “whole person.”
As with all benefits, the burden is on the injured worker to demonstrate their entitlement to benefits. Here, an injured worker must prove the existence of functional impairment proximal to the shoulder joint. Given the location and versatility of this joint, there are a variety of ways to meet this burden and as you can see, it is often worth it. My advice is to take your time in filling out pain diagrams and note where (anatomically) all of the problems are, and communicate the same to your physicians, therapists, masseuses, etc. If you are having issues proximal to the shoulder joint and they are well documented, you can leverage your award for permanent impairment.