Source: https://ash.law/2018/03/02/oklahoma-back-neck-spine-disc-injury-settlements/
Timestamp: 2019-04-18 11:09:43+00:00

Document:
When it comes to Oklahoma Workers’ Compensation settlements and awards, back, neck, spine and disc injuries predominate. Slips, falls, lifting injuries, falling objects and direct impact to the back and spine usually cause the damage. Whatever the condition, herniated, protruding, torn, bulging or slipped discs, compression and/or wedge fractures, these injuries most likely will lead to permanent injury and damage. Symptoms of serious spine and disc injury cases include back pain, weakness, sciatica, lumbago, radiculopathy, range of motion loss or even foot drop. Treatment for these conditions can be complicated and protracted. To make matters worse Oklahoma Workers’ Compensation Law has now enacted serious limits on how long an injured Oklahoma worker can draw weekly benefits for what the Workers’ Compensation Court defines as a “soft-Tissue” back, neck, spine and disc injury case.
As far as treatment, in most cases, an injured Oklahoma worker will simply receive a plain x-ray to diagnose the condition. However, inexpensive x-rays will merely show any serious injury or damage to the workers’ bone, or in the case of back, neck and spine cases, the condition of his or her vertebra. However, most serious worker’s compensation back and spine injuries are to the employee’s discs and/or other soft tissue structures, including ligaments, muscles and other supporting structures. In order to properly diagnose these conditions more sophisticated or invasive diagnostic studies or testing will be in order, such as an MRI, CT scan, myelogram, discogram, EMG or even Nerve Conduction Studies.
Employers and their Oklahoma Workmans’ Comp Insurance Companies will generally resist providing an injured employee with more expensive diagnostic tests, not only to avoid the obvious and direct cost of the procedure itself, but to prevent the proper and timely diagnosis of a more serious structural injury within and around the workers’ spine. This is because more serious disc injuries typically result in extended time away from work, wage loss and permanent disability. Serious disc injuries usually do not heal on their own, and usually have to be treated with narcotic pain, muscle relaxers, and/or anti-inflammatory prescription medication, physical therapy, epidural steroid injections (ESI’s) and/or nerve blocks. Many disc and spine injuries can only be repaired with surgery, including a laminectomy or discectomy procedure, and in many serious cases lumbar fusion using rods, cages or other orthopedic hardware. Serious neck injuries usually are treated with a anterior cervical discectomy and fusion (ACDF) procedure. These surgical procedures are generally performed by either or both an orthopedic surgeon or neurosurgeon, or when an anterior lumbar approach is utilized, a general surgeon.
Even following recovery from a successful surgical procedure to his or her spine, many injured workers in Oklahoma will required protracted or even lifetime treatment from a pain management clinic or physician. In Oklahoma this post-recovery treatment, termed ‘continuing medical maintenance’, is generally disfavored and can only be secured by a a court order handed down from the Oklahoma Workers’ Compensation Commission specifically describing and setting forth the precise nature and extent of this continuing medical maintenance or treatment. In many cases a worker’s back or neck pain is so severe that placement of a dorsal spinal cord stimulator or other implantable device will be needed to relieve the injured worker from his or her protracted pain or other symptoms. Such a device will require long-term if not lifetime adjustment, replacement, battery charges and other routine maintenance.
Under Oklahoma Workers’ Comp law an injured workers’ employer has the right, if not the duty, to select a doctor to treat the employees’ back, neck, spine or disc injury. However the Oklahoma Workers’ Compensation Court does allow an injured worker a one-time right to change his or her treating physician from the one designated by his or her employer’s insurance company. It should be noted that this change of treating physician requires a formal process and court order designating a new treating doctor for the injured worker, and should only be done with the assistance of an experienced Oklahoma Workers’ Compensation attorney, as any mistakes or delay and initiating or following these procedures could result in the injured worker choosing the wrong physician specialty or doctor or even worse losing his or her opportunity to select or change his or her physician at all.
As will be further discussed below, Oklahoma Workers’ Compensation law provides serious limits on a workers’ ability to receive wage loss and/or other cash benefits for what is described as a ‘soft-tissue’ injury or damage. To be clear, Oklahoma injured workers who do not receive either a spinal injection, a back surgery, or merely a recommendation of a back surgery by a neurosurgeon or orthopedic surgeon, will be limited to eight weeks of temporary total disability or wage loss benefits. Understanding this it is imperative that injured employees in Oklahoma contact a workers’ compensation attorney as soon as possible following a back, neck or disc injury to get a proper diagnosis and treatment to avoid incurring uncompensated wage loss and increased injury and spine damage caused by a delay in receiving proper treatment.
The Oklahoma Workers’ Compensation Act specifically states that the statutory benefits available to an hurt worker covered under the Oklahoma Workers’ Compensation Law are the only rights &/or remedy available to that worker &/or his or her legal representative vis a vis that injured worker’s employer. In other words-Oklahoma employers are immune from lawsuits or other civil claims or actions for damages by employees who sustain job-related Disc, Spine, Back & Neck injuries. Such a worker is entitled to whatever benefits he or she may be entitled to under the Oklahoma Workers’ Compensation Law if his or her injury is one covered by that Act.
Back and neck injury cases that are covered or that are otherwise ‘compensable’ under the Oklahoma Workers’ Compensation Act are those that cause damage or harm to the physical structures that make up that worker’s vertebra, disc(s) or other supporting structures of the spine (including prosthetic devices, appliances or hardware previously placed in or near that worker’s spine). Such damage or defect must be caused or come about as a direct and proximate result of either an accident, cumulative trauma or occupational disease arising out of the course and scope of that employee’s employment.
The phrase “course and scope of employment” includes back and neck injuries caused from performing work or other activity carried out on the premises of an employer or at other locations prescribed or designated by the employer and necessarily includes business travel by the worker which does advance or further the interests that is specifically directed by the employer.
A consequential or compensatory injury to a separate part of an injured worker’s body which flows or is as a direct result of medical treatment or is proven to be caused by that worker’s original back, spine or neck injury is compensable and covered by the Oklahoma Workers’ Compensation Act. The Oklahoma Workers’ Compensation Court has determined that a consequential or compensatory back, neck, spine or disc injury case is one that comes about and is otherwise caused by injury or medical treatment to the part of the injured worker’s body that is the subject of the worker’s original work comp claim.
Under Oklahoma law the Workers’ Compensation Court cannot make a proper finding of a consequential or compensatory injury unless or until is is proven by the injured employee &/or his or her Oklahoma City or Tulsa Workers’ Compensation Attorney with objective medical evidence that medical &/or surgical treatment for that consequential injury was or is needed or required.
In Oklahoma a worker and/or his or her Workers’ Compensation Attorney must prove that the employee’s work was the ‘major’ or predominant cause of his or her back, neck, disc or spine injury. Such proof must be by medical evidence from a physician or doctor describing objective findings of injury or disease to the injured worker’s back, neck, vertebra, disc(s) or other supporting structures of the spine. Title 85A § 2.9.c & d Oklahoma Workers’ Compensation Commission rules require that any medical opinion put before the court addressing the compensability of disc, spine, back and neck injury cases must be stated within a reasonable degree of medical probability.
Oklahoma Workers’ Compensation Commission has said the term “major cause” means greater than fifty percent (50%) of the resulting injury, harm, disease, illness or other medical condition affecting a workers’ spine, back or neck.
Any sprain, degeneration or arthritic process (i.e. degenerative disc disease or degenerative joint disease) or damage, harm or condition of the structures surrounding an injured worker’s back, neck, discs or spine resulting from the natural aging process (to include arthritis, osteoarthritis, osteoporosis, spondylosis, spondylolisthesis and/or stenosis) are not covered by the Oklahoma Workers’ Compensation Law. Title 85A § 9.b(5) However-these conditions can be covered if a substantial and identifiable aggravation occurs to the underlying condition resulting in disability to the worker and the need for treatment to the worker’s neck, back or spine-over and above that which the worker was previously receiving.
Any preexisting injury or condition caused to an injured employee’s back, neck, spine and/or disc(s) will not be covered by the Oklahoma Workers’ Compensation Law, unless the hurt worker’s treating physician plainly confirms that his or her patient sustained an identifiable and significant aggravation of his back or neck condition caused by events or circumstances arising out of and in the course and scope of the worker’s employment. Title 85A § 9.b(6) The Oklahoma Workers’ Compensation Court has defined a “pre-existing condition” to be any injury, disease, sickness, mental condition or the like (whether work-related or not), for which an injured worker had been recommended or otherwise received medical advice, a diagnosis, or medical treatment all preceding the date of injury in the case at hand.
Neck, back, spine and disc injuries that occur during or as a result of: (1) assaults & horseplay 85A § 9.b(1); (2) recreational or social activities 85A § 9.b(2); and (3) as a result of intoxication from either alcohol, medication or illegal drugs 85A § 9.b(4) are not covered under the Oklahoma Workers’ Compensation Law.
Oklahoma Workers’ Compensation Benefits are not payable for any injury or disease caused from an independent & intervening non-work related injury and/or accident which occurs following an otherwise compensable injury which creates or even prolongs recovery and/or disability from that original compensable injury or disease. Title 85A § 9.f This exception does not apply to intervening accidents &/or injuries which are consequential or as a result of the original back or spine injury case. Consequential injuries are fully discussed above.
Back, neck, spine and disc injuries cases which happen during or while the worker is transporting himself or herself to the workplace or worksite are not covered under the Oklahoma Workers’ Compensation Law. This is commonly known as the “coming and going” rule. Title 85A § 13.a This exception does not apply to those workers traveling to a remote job site or transporting work, his or her employer’s vehicle, co-workers or other items to or from his or her workplace-or if that worker is paid mileage for his or her travel.
Back, neck, spine and disc injuries that occur during or as a result of travel by the injured worker that is in furtherance of the business or trade of his or her employer–but which also inures to the benefit of that injured worker as well, are not covered under the Oklahoma Workers’ Compensation law. This is known as the “dual purpose” doctrine.
Parking lot accidents: Back, Neck, Spine and Disc injury accidents occurring in or on any parking lot or other type of common area next to or adjoining a worker’s place of work which accident occurs before the worker clocks in or otherwise begins his or her work duty or arrives at his or her work station (or following the working clocking out or finishing his or her assigned work duties) are not covered under the Oklahoma Workers’ Compensation Act.
Work Break Injury(ies): Unauthorized or off-site back, neck, spine and disc injury cases which occur during, while or as a result of a work break are not covered by Oklahoma Workers’ Compensation Commission rules.
Any hurt worker claiming or otherwise eligible for compensation for his back, neck, or spine injury under the Oklahoma Workers’ Compensation Act, must, if ordered by the Oklahoma Workers’ Compensation Court (or properly requested to do so by his or her employer or its insurance company), submit himself or herself to medical examination and/or diagnostic testing to be performed by an Independent Medical Examiner other than his or her treating physician. Any injured worker who neglects or otherwise refuses to submit or in good faith participate in such an independent examination will have his or her right to prosecute any proceeding under the Oklahoma Workers’ Compensation Act suspended during any period of time such refusal to participate in the examination persists-and any compensation otherwise due and payable during the period will not be paid. As is more fully described below – any injured worker, asked to go to either a court ordered or employer requested independent medical examination, will be paid statutory mileage and other travel related expenses for use in attending the examination. 85A § 53.A & B.
Note: The Oklahoma Workers’ Compensation Commission has said the term “Maximum Medical Improvement” means that no further improvement can be expected from additional medical treatment or the mere passage of time.
Diagnostic testing: Diagnostic and radiographic tests such as an EMG, CT Scan, MRI, X-ray, Myelogram, Discogram, Bone Scan, Ultrasound and the like cannot be provided as part of a continuing medical maintenance program for an injured Oklahoma worker.
Surgery: Any type of Surgical procedure such as laminectomy, discectomy, artificial disc and/or anterior or posterior fusion procedures utilizing cages, plates or rods will not be authorized by the Oklahoma Workers’ Compensation Court once an injured worker reaches maximum medical improvement for his or her back, neck, spine or disc injury.
Spinal Injections, Spinal or other diagnostic or therapeutic injection procedures, including epidural steroid injections (ESI) and Stellate Ganglion Block procedures will not be provided to an injured worker as part of his or her continuing medical maintenance program.
Mental Health Counseling: Any type of psychotherapy or other mental health counseling which could help an injured worker maintain control of his or her depression, anxiety or psychological overlay caused or consequential to the original compensable Spine, Disc, Back or Neck injury case will not be awarded as continuing medical maintenance by the Oklahoma Workers’ Compensation Court.
Physical Therapy: Any passive or active physical therapy, to include chiropractic, massage, traction, aquatic, manipulation, acupuncture, dry needling or the like, even if recommended by the hurt worker’s treating doctor, cannot under Oklahoma Law by Awarded by the Oklahoma Workers’ Compensation Court.
Medical Devices: The initial trial and/or placement of any pain management device or other durable medical equipment including, but not limited to, any trial or permanent placement of a Dorsal Spinal Cord Stimulator (SCS), TENS Unit, Morphine or Pain Pump or any other implantable medical device will not be provided to an injured worker under Oklahoma law once that worker reaches maximum medical improvement (MMI) for his or her back, neck, spine or disc injury condition. However, routine maintenance and/or replacement of a previously provided and/or placed device can and probably will be ordered as a routine item of a continuing medical maintenance plan-as further discussed below.
Note: If any of the above described treatment or procedures are needed by the injured worker once he or she reaches maximum medical improvement it will be necessary for that injured worker, or his Oklahoma City or Tulsa Workers’ Compensation Attorney, to reopen his or her case following Oklahoma Law-a process described more fully below.
An employer in Oklahoma, or that employer’s workers’ compensation insurance company, is only responsible for paying for continuing medical maintenance (or pain management) that is within the prescribed treatment guidelines set forth in either one or both of the following publications: (1) Physician Advisory Committee; or (2) The Work Loss Data Institute’s Official Disability Guidelines (ODG). These guidelines are discussed in more detail above.
The current rate for reimbursement for mileage incurred for Oklahoma Workers’ Compensation cases is 58¢ per mile.
A mileage check will be paid for mileage as described above, as well as toll charges, for travel to and from an injured worker’s treating doctor, Court-ordered IME’s as well as insurance company IME’s. Mileage will not be paid for an injured worker to travel to court, depositions, as well as other meetings with lawyers, nor will it be paid for any injured worker to attend a medical examination with an unauthorized treating doctor or a physician selected or paid for by the injured worker’s attorney.
Oklahoma Workers’ Compensation Attorney Practice Pointer: Most employers and their workers’ compensation insurance carriers in Oklahoma do not exercise the option to use a certified workplace medical plan as these plans can be quite difficult to administer and do not generally result in curtailing either the costs or treatment that an injured worker would otherwise receive under a more traditional workers’ compensation treatment protocol-even in complicated spine and disc surgery cases.
When evaluating what is appropriate treatment for job-related spine and disc injuries in Oklahoma the Workers’ Compensation Commission considers the current edition of the “Official Disability Guidelines” or ‘ODG’ published by the Work Loss Data Institute as an authoritative guide. In fact the Oklahoma Workers’ Compensation Court has stated that the Official Disability Guidelines – Treatment in Workers Compensation (ODG), published by the Work Loss Data Institute is to be recognized as the primary standard of reference, at the time of treatment, in determining the frequency and extent of treatment and services presumed to be reasonable and medically necessary and appropriate for compensable injuries in Oklahoma, or in resolving disputes resolving what treatment is reasonable and necessary in an individual case.
The Oklahoma Workers’ Compensation Court has been clear, however, that these medical treatment guidelines are not strict requirements, not mandates or practice standards, but they do provide some practical advice by recognizing the treatment and care likely to most benefit hurt employees in an individual case. This is because generally these guidelines are evidence-based, scientifically valid, outcome focused, and designed to reduce or eliminate unnecessary, inappropriate, duplicate or even protracted care and treatment while making sure injured workers do, indeed receive reasonable and timely medical care and treatment.
The Oklahoma Workers’ Compensation law does require that doctors treating injured workers prescribe for those employees necessary prescription drugs as clinically appropriate and as outlined under the Official Disability Guidelines. In fact, prescription drugs that are not preferred, exceed or are not addressed by ODG require preauthorization and that preauthorization request must include the prescribing doctor’s drug regimen plan of care and the anticipated dosage or range of dosages.
The Oklahoma Workers Compensation Court describes a ‘Prosthetic Device’ as one used to repair or replace a part or joint of the body that is lost or injured in a compensable work-related accident or illness.
Pain Management or other Medical Devices or Equipment, including, but not limited to any trial or permanent implantation of a Spinal Cord Stimulator (SCS), TENS Unit, Morphine or Pain Pump or any other implantable medical device.
It is illegal for any doctor, clinic or other medical provider or hospital to bill for payment or attempt to collect any fee (or any portion thereof) for treatment or services rendered to an injured worker as part of that patient’s workers’ compensation case. It is likewise illegal for any hospital, surgeon, therapist or the like to report any workers’ compensation patient to any credit-reporting agency for that patient’s failure to pay such medical bill.
NOTE: This prohibition against a medical care provider billing, seeking payment from or reporting a workers’ compensation patient to a credit-reporting agency only takes effect upon an injured employee &/or that employee’s Oklahoma Workers’ Compensation attorney properly filing with the Oklahoma Workers’ Compensation Court that workers’ initial claim for compensation and also properly giving that worker’s medical providers actual written notice sent to the medical provider by certified mail. Said notice must necessarily include the name or names of the responsible employer and/or the workers’ comp insurance company (if known), the hurt employee’s name, the details of the injury, and finally the workers’ compensation claim number, if known.
Of course, if a workers’ back, neck, disk or spine injury claim is found to be not compensable by the Tulsa or Oklahoma City Workers’ Compensation Commission, then the hospital, clinic or physician’s office will be lawfully permitted to collect from the worker any unpaid portion of the medical bill or any other charge for medical services provided to that employee. In addition, any statute of limitations that would otherwise apply to collection of the medical, hospital or surgical bill will be tolled up to and during the time the case is pending and until a final unappealable determination is made that the workers’ back, neck, disc or spine injury is not compensable under the Oklahoma Workers’ Compensation Law.
Worker Entitlement & Amount of TTD Benefit Check in Oklahoma: In Oklahoma an injured worker, unable to perform the duties of his or her regular job assignment (or any “light-duty” or alternative work properly offered to him or her by the employer) as a result of limitations imposed by his or her back, neck, spine or disc injury, should, by law, be paid Temporary Total Disability (or ‘TTD’) compensation during the period of that worker’s total incapacitation. Such TTD benefit under Oklahoma Workers’ Compensation Law is to be paid at seventy percent (70%) of the hurt employee’s pre-injury average weekly wage (computation of which is described below). The periodic amount is paid weekly and also subject to a statutory maximum benefit cap, currently set at $590.63 per week. This maximum benefit amount or cap is usually raised every year on November 1st and is computed at 70% of Oklahoma’s average weekly wage for the preceding year.
How Long is Temporary Total Disability Paid under Oklahoma Workers’ Comp Law?: TTD in Oklahoma for a back, neck, spine or disc injury case is paid for the duration of the injured worker’s total incapacity to work, up to a maximum of one-hundred four (104) weeks, obviously benefits are subject to a statutory cap of two years duration, unless there is a compensable ‘consequential injury’, all as discussed in the next section.
Additional Year of Temporary Total Disability Payments Available for Worker with a “Consequential” Back, Neck, Spine or Disc Injury: In Oklahoma, a worker who can prove that he or she has sustained what is termed a ‘consequential’ back, neck, spine or disc injury, or that his or her original back or neck injury (or treatment for that condition) has caused or resulted in injury to a new or separate body part or system, and that he or she needs additional time to heal from that condition, TTD will be paid for an additional period of no more than an fifty-two (52) weeks. Any award of an additional period of TTD beyond the initial two year period must be proven by ‘clear and convincing’ evidence–a burden much higher than required to prove entitlement to other benefits under the Oklahoma Workers’ Compensation system.
The Oklahoma Workers’ Compensation Commission has said that the term “pre-injury or equivalent job” means the job title or position the injured employee was performing for his or her employer at the time his or her back, neck, spine or disc injury happened (or any other job offered to said injured worker by said employer that pays at least one-hundred percent (100%) of that injured worker’s pre-injury average weekly wages, or ‘AWW’, defined elsewhere on this site).
Three Day Waiting Period Applies to TTD Benefits Paid in Oklahoma: In Oklahoma a worker suffering a compensable back, neck, spine or disc injury will not be paid a TTD check for the first three days of the initial period of total disability–in other words, if an injured worker returns to work, is released from treatment, or his or her TTD check is properly terminated for any other reason, he or she will not suffer another three-day waiting period if he or she should reinitiate active medical treatment and be forced off work again for his or her injury.
The Oklahoma Workers’ Compensation Court has determined that the term ‘surgery’ specifically does not include an epidural steroid injection, sympathetic nerve block or other type of injection or otherwise the placing of fluids beneath the injured worker’s skin for medical reasons, regardless of whether for treatment or diagnostic purposes.
Abandon’s Medical Care: Any other reason where it is proven that the worker fails to follow through with his or her medical doctor or treatment.
The employer (or most probably its workers’ compensation insurance company) must first notify the injured employee (or said hurt worker’s Oklahoma City or Tulsa workers’ comp attorney) of its intent and the reason it feels justified to terminate the worker’s cash benefit check. Such notification must be in writing and is generally accomplished by the employer simply filing with the workers’ comp commission a Form 13 REQUEST FOR PREHEARING CONFERENCE and designating thereon the issue of “Motion to Terminate Temporary Compensation”.
The injured worker (or again that employee’s Oklahoma City or Tulsa workers’ compensation lawyer) then has ten (10) days (from the date of the employer’s notice to terminate TTD) to file an objection to termination of his or her temporary benefit with the Oklahoma Workers’ Compensation Commission. This is generally accomplished by the injured employee filing with the Commission his or her own Form 13 REQUEST FOR PREHEARING CONFERENCE endorsing the issue “Objection to Termination of Temporary Compensation”.
If the injured worker or his Tulsa Work Comp Lawyer timely and otherwise properly lodge an objection to termination of his or her TTD check the Oklahoma Workers’ Compensation Commission will for-with set the matter down for a court hearing to determine whether TTD payments should be restarted. Pursuant to Oklahoma workers’ compensation law this hearing is to be set within twenty (20) calendar days of the injured workers’ attorney filing the objection to such termination.
Worker cannot receive a TTD and unemployment check at the same time: An injured worker in Oklahoma cannot receive a Temporary Total Disability check for any week in which that worker also receives an unemployment check from the Oklahoma Employment Security Commission or the unemployment laws of another state.
Exception where Temporary Total Disability Benefits are contested: If a worker’s Temporary Total Disability Benefits are contested or otherwise delay, and it is later determined or that worker is awarded past-due benefits for TTD a Temporary Total Disability Benefit will be paid to that injured worker for any week that worker also receives unemployment compensation. However, the injured worker’s TTD benefit will be reduced by the amount of his or her unemployment benefit for that same week period.
The Oklahoma Workers’ Compensation Commission has determined that the term “Temporary Partial Disability”, or ‘TPD’ refers to a hurt worker who is temporarily unable to perform his or her regular job duties, but can perform alternative or ‘light duty’ work which has been offered to him or her by the employer where the employee was working when he or she got hurt (or really even another or new employer who offers the employee work paying less than that worker’s pre-injury wage). Obviously the light duty job being offered has to be either for the injured worker to work less hours, earn less per hour worked, or even both, as long as the injured worker is making less overall than he or she was making all before the injury occurred.
Amount of Temporary Partial Disability Check in Oklahoma for Back, Neck, Disc or Spine Injury Case: In Oklahoma, any hurt employee, who is still under active medical treatment (i.e. he or she has not achieved maximum medical improvement) and is unable, as a result of his or her back, neck, spine or disc injury, from doing his or her pre-injury job (or another job equivalent in pay), but has been offered and is working light-duty work offered to him or her, will be paid a TPD check computed at seventy-percent 70% of the difference between that hurt employee’s average weekly wage before he was hurt, and his or her average weekly earnings made while performing his or her light-duty work. Again, this temporary partial disability settlement is only paid when the injured worker’s light duty assignment pays less per week than the injured worker’s job that he or she was doing at the time the injury occurred. 85A § 45.B.
Duration of Temporary Partial Disability Settlement Check in Oklahoma: A temporary partial disability check under Oklahoma Workers’ Compensation Commission rules is capped, i.e. will not be paid beyond, fifty-two (52) weeks.
The Oklahoma Workers’ Compensation Act describes “Permanent Partial Disability” to be the nature and severity, expressed as a percentage loss of use of the total capabilities of a human body and is only determined after the injured worker has achieved maximum medical improvement–all as proven by competent medical evidence and opinion.
When making a permanent partial disability impairment rating to an injured worker’s neck, back, discs or spine a rating doctor in Oklahoma must follow the sixth edition of the American Medical Association’s “Guides to the Evaluation of Permanent Impairment”.
As with all civil injury cases–Oklahoma Workers’ Compensation Court rules require that any medical opinion or evidence put before the court addressing permanent disability or impairment to a hurt worker’s back, neck, intervertebral discs or lumbar or cervical spine must be phrased within a reasonable degree of medical certainty or probability–or such evidence will be excluded from consideration by the court.
When determining permanent partial disability awards or settlements doctors and judges in Oklahoma cannot consider the injured worker’s subjective complaints of pain and other symptoms and all such evaluations must be supported by objective medical findings and evidence.
There are traditionally two types of permanent partial disability awards or settlements under Oklahoma Workers Compensation law. “Scheduled Injuries” are by and large those that affect the injured worker’s extremities or senses (i.e. fingers, hands, wrists, elbows, feet, ankle, eyes and ears) and are generally determined by taking the percentage loss that bears to the number of weeks for that injured body part as found on a schedule. On the other hand injury to an individual’s neck, back and spine, as well as other “whole body” or “whole person” injuries (i.e. shoulders, head, hips) are determined by taking the injured worker’s impairment to his body as a whole as a percentage of three-hundred fifty (350) weeks. 85A § 45.C.8.
EXAMPLE: A worker has pre-injury earnings which computed under Oklahoma Law entitles that worker to a weekly Temporary Total Disability check of $440.00. Under Oklahoma Law his Permanent Partial Disability Settlement will be capped at $323.00 per week. The worker injured his or her neck and received a two level cervical fusion. The Oklahoma Court has determined, based upon that surgery and the nature of his or her neck injury, that he or she has a thirty percent (30%) permanent partial disability rating. His or her Permanent Partial Disability Settlement would be computed at $33,915.00 ($323.00 rate x 30% disability x 350 weeks).
Any demand or request for a permanent partial disability award &/or settlement for a back, spine disc or neck injury brought by an injured worker must be fully supported by competent medical testimony from a medical doctor, osteopathic physician, or a chiropractor. Unfortunately in Oklahoma an injured worker and/or his or her Oklahoma City or Tulsa Workers’ Compensation Lawyer must go forth and pay for an examination with a physician and submit to the Court a medical report supporting that workers’s permanent impairment and disability before a permanent disability award will ensue.
NOTE: Any award of PPD or impairment made by an Oklahoma Workers’ Compensation judge which is not otherwise supported by objective medical findings made by a treating physician who is also a medical doctor, doctor of osteopathy, chiropractor or a qualified independent medical examiner will be considered on appeal as a abuse of judicial discretion and vacated.
INJURED WORKER’S AWARD OR SETTLEMENT FOR PERMANENT PARTIAL DISABILITY WILL BE REDUCED BY PERCENTAGE OF IMPAIRMENT THAT EXISTED AT THE TIME OF HIS OR HER CURRENT BACK OR NECK INJURY CASE: The simple fact that an injured worker has suffered a previous injury or obtained disability for a prior back, neck, spine or disc injury will not automatically preclude that worker from receiving a permanent partial disability award or settlement for a subsequent accident or injury to his or her spine. However – in that situation where there exists a prior or previous PPD disability, award and/or settlement (including any prior non-work related injury or disability) and that disability is accelerated or aggravated by the later work-related event, monetary compensation for permanent partial disability will only be paid for that amount that was caused by the later work-related accident and/or injury. Certainly no compensation will be paid for the pre-existing disability or impairment in the current back or neck injury case.
An hurt worker whose neck, back or spine injury is serious enough to cause him or her to otherwise be eligible for a permanent partial disability settlement or award from the Oklahoma Workers’ Compensation Commission will also be eligible to receive vocational retraining to be provided by a technology center and/or public secondary school offering vocational-technical education courses (or a member institution of the Oklahoma State System of higher education). Training under Oklahoma Worker’s Comp law will include, as appropriate, retraining and/or job placement with the goal to put the hurt worker back to gainful employment. All tuition and other retraining expenses related to vocational rehabilitation services are to be paid by the injured worker’s employer and/or its insurance company directly to the school, college or other facility providing vocational rehabilitation services to the injured worker.
Three, four, or five level positive discogram of either or both the cervical or lumbar spine which has been surgically treated.
If an injured worker’s selected training and/or rehabilitation program requires that he or she reside at that facility or away from the worker’s usual and customary place of residence – the reasonable cost of that injured worker’s room/board/lodging and travel – as well as the usual tuition, books and necessary equipment necessary for the training program will be paid by the injured worker’s employer or the employer’s worker’s compensation insurance company. In addition – where the injured worker is required to stay at the training or school facility or is otherwise required to stay away from the worker’s usual and customary residence that worker will also be entitled to an indemnity or weekly disability check all while and during the time he or she is required to be away from his or her residence for his or her retraining program. The amount of this weekly wage replacement or income check will be the same and calculated at the rate of his or her temporary total disability (TTD) benefit check – i.e. seventy percent (70%) of his or her average weekly wage (AWW).
An employer and/or its workers’ compensation insurance company can unfortunately deduct from any final award or settlement payable to an injured worker the amount said employer paid on behalf of the injured worker for his or her retraining program.
The Oklahoma Workers’ Compensation Commission has said that “Permanent Total Disability” or simply “PTD” in Oklahoma means that a worker, because of his or her industrial neck, back, spine or disc injury, now has the incapacity to earn any wages in any employment for which said worker may be or become suited by education, training, experience or vocational rehabilitation. The statute goes further by stating that any back, neck or spinal cord injury which causes an injured worker to become paralyzed or otherwise lose his or her ability to control either both hands, both legs, both feet or any combination thereof will be deemed PTD under Oklahoma Work Comp law. This is called “statutory permanent total disability” or “presumptive permanent total disability”. Certainly any Oklahoma worker rendered a quadriplegic or paraplegic from a spinal cord injury or damage caused by his or her industrial accident will be deemed or found Permanently and Totally disabled under Oklahoma law.
NOTE: If it is the case that the Oklahoma Workers’ Compensation Commission issues both a Permanent Partial and a Permanent Total Disability award the PTD award or settlement will not begin payment until the full PPD award is paid out.
“Gainful Employment” has been defined by the Oklahoma Workers’ Compensation Court to mean an injured employee’s ability or capacity to perform work for money or wages that is not sporadic, occasional or casual.
An injured worker, sustaining serious and permanent burns, scars and disfigurement as a result of his or her back, neck, disc or spine injury may be awarded a lump sum disfigurement settlement up to a maximum amount of $50,000.00 by the Oklahoma Workers’ Compensation Court. An award of disfigurement in Oklahoma cannot be made until at least twelve (12) months have passed after a worker’s injury causing such disfigurement.
In Oklahoma an injured worker cannot receive both a disfigurement award and a permanent partial disability settlement to the same part of the body. This requires, where an injured worker has both scarring, burns and disfigurement as well as a permanent orthopedic, neurologic or other anatomical injury, to choose between receiving either an award for disfigurement or a permanent partial disability settlement. In other words he or she cannot receive both.
EXAMPLE: Most typically when an injured worker gets neck surgery in Oklahoma the surgeon will remove bone from that worker’s hip to put in the worker’s neck to replace the disc and otherwise complete the fusion. In such case the injured worker cannot get both disfigurement to his or her neck from the scar where the surgeon went in to the worker’s neck to perform the surgery in addition to permanent partial disability for the neck fusion. He is she must choose one or the other. The worker, however, can get a disfigurement award for the scar on the worker’s hip caused from the procedure performed to remove bone from the worker’s pelvis to complete the fusion. In virtually all cases the injured worker and/or his or her worker’s compensation attorney will elect to receive permanent partial disability for the neck injury and fusion, as undoubtedly the impairment from such an injury and resulting surgery will yield more in monetary benefits than the disfigurement from the scar left from the actual surgical procedure. In other cases the decision may not be so clear, however.

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