Claimant: “Take my word for it — my back is really rigid, even though my examination is normal.”
Panel: That’s good enough for a Table 53 rating.
Panel holds that no objective evidence of rigidity is required for a Table 53 rating and assignment of impairment.
Claimant sustained a compensable accident and alleged neck “tenderness” during palpation by his authorized treating physician (ATP) early in his treatment. However, he was placed at maximum medical improvement (MMI) after his ATP determined that he had “minimal objective residual problems” and had “full range of motion” and “normal spinal/paraspinal” symmetry. Respondents filed a final admission of liability (FAL) and claimant obtained a Division Independent Medical Examination (DIME) with Dr. Thomas Higginbotham.
Dr. Higginbotham recorded a myriad of subjective complaints, including claimant reporting a “sharp pull” in his neck, but Dr. Higginbotham recorded only “tenderness” based on claimant’s subjective report during the exam, and documented no objective signs of rigidity. Dr. Higginbotham provided both a Table 53 and range of motion (ROM) rating for the neck and respondents challenged the rating.
The Administrative Law Judge (ALJ) held that DIME was overcome based on the testimony of respondents’ expert that the DIME should not have provided a Table 53 rating because Dr. Higginbotham never documented any objective signs rigidity from an examination in his report — only claimant’s subjective report of rigidity.
A Panel of the Industrial Claim Appeals Office (Panel) reversed the decision, noting the requirement in the AMA Guides for “six months of medically documented pain and rigidity” before a Table 53 rating may be issued does not require that the rigidity be objective. The Panel remanded the case for additional findings to the ALJ.
Bryan v. Transit Mix Concrete and Travelers Indemnity Company, W.C. No. 5-058-044 (ICAO June 5, 2019).
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