This is a medical evaluation to determine if there has been a permanent loss of function caused by your work-related injury. This evaluation is completed once it appears that no future treatment will make a significant difference in your outcome (your body has healed to the best of its ability) or when you do not desire any further treatment.  This evaluation is a normal part of the workers compensation process and is a way to put a number on the loss of function for your injured body part(s) as compared to your normal pre-injury self.  This evaluation allows the injured worker to potentially receive compensation for his/her permanent loss of function.  In fact, your workers compensation carrier is required to allow you to have this evaluation (Under Labor rule RSA 281-A:32 in New Hampshire and 21 VSA §648 in Vermont).  After a thorough review of the records and a detailed physical examination, Dr. Dent will complete a report.  In this report, he will document his findings and calculate your Permanent Impairment Rating using a book published by the American Medical Association (AMA).    

Once Dr. Dent has completed the report, he will send it to your Workers Compensation carrier.  If the carrier accepts Dr. Dent’s Permanent Impairment Rating, they will contact the injured worker or his/her representative.  Compensation will be paid to the injured worker based on the calculation completed on the Permanent Impairment Rating report.  Please note that by accepting this compensation, you are not “settling” or signing away your medical benefits in regards to your workers compensation injury.  You will still have medical coverage for your work related injury.   

Dr. Dent’s office will contact you to schedule an appointment for this evaluation.  The face-to-face part of this evaluation typically takes 45 minutes to 1 hour.  Your report will typically be sent into the Workers Compensation carrier within one week.  (Please note that since this evaluation is part of the workers compensation process, you should keep track of the miles driven to the evaluation, the time for the evaluation, and the miles driven to travel back from the evaluation.  You should submit this for reimbursement similar to any other medical or physical therapy visits.)      

Make sure to bring a current and valid state or federally-issued photo ID.  Make sure that you have plenty of time to get to and from the evaluation on your scheduled evaluation day.  You should make sure to wear clothes in which the injured area can be exposed to Dr. Dent (example: if your knee is being evaluated, make sure to wear or bring shorts).  Please note that if anyone comes to the evaluation with you, they will not currently be permitted to come into our building with you.     

Your evaluation with Dr. Dent will occur at 106 Hanover Street, Suite #2 in Lebanon, NH 03766

An IME is the evaluation of an injured individual by an independent medical professional to issue an unbiased opinion on the individual’s work-related injury.

Impairment is assessed when an injured worker reaches a medical end result (MER) or maximum medical improvement (MMI) for the work injury or condition. Impairment must be determined by a medical expert and pursuant to the AMA Guides to the Evaluation of Permanent Impairment (5th ed.). It is the adjuster’s responsibility to take the steps necessary to determine if the injured worker has a permanent impairment once MER or MMI has been reached. Benefits are paid in accordance with 21 VSA §648. https://labor.vermont.gov/sites/labor/files/doc_library/Part%204-indemnity-benefits-adjusters-manual.pdf  accessed on 1/19/2023

“Doctors use these terms to signify that no further treatments are likely to improve your condition significantly, and that you have therefore reached a plateau in your medical recovery. A finding of end medical result may be used as the basis for discontinuing wage replacement benefits, provided a Form 27 is fi led with the Vermont Department of Labor and approved. You have a right to file a written appeal with the Department. We encourage you to fi le as soon as possible if you choose to appeal.”  From the Vermont Department of Labor https://labor.vermont.gov/sites/labor/files/doc_library/Work%20Injuries%20brochure_0.pdf Accessed on 1/19/2023

Yes.  Per the Vermont Department of Labor: “If an injured worker is left with a permanent impairment or loss of function as a result of the work injury, he or she is entitled to additional compensation, referred to as permanent partial disability compensation (PPD).” https://labor.vermont.gov/sites/labor/files/doc_library/Part%204-indemnity-benefits-adjusters-manual.pdf accessed on 1/19/2023

Yes.  “Permanent partial disability (PPD) is an additional monetary benefit that the injured worker may be entitled to under Vermont’s workers’ compensation act. PPD is intended to compensate an injured worker for any permanent loss of function that results from the work injury. Compensation is payable for a specific period of time dependent upon the degree of impairment.”  https://labor.vermont.gov/sites/labor/files/doc_library/Part%204-indemnity-benefits-adjusters-manual.pdf  accessed on 1/19/2023

Yes.  Per the Vermont Department of Labor: “The insurer must inform the injured worker of his or her right to obtain at least one permanency examination and impairment rating, at the carrier’s expense. See Rule 11.2400 (for injuries prior to 4/1/95 Rule 11.1530 applies). The insurance carrier may request that the injured worker attend an examination with its own medical expert at reasonable times and places.” https://labor.vermont.gov/sites/labor/files/doc_library/Part%204-indemnity-benefits-adjusters-manual.pdf  accessed on 1/19/2023

Yes!  To assure the best result from this evaluation, you should have a doctor who knows how to do these specialized evaluations and has significant experience in completing these evaluations.  Otherwise there is a risk for improper evaluation to delay the claim for a significant amount of time.  An improper evaluation may also undershoot or overshoot the appropriate Impairment Rating.  Both of these results cause problems for the claimant and the insurance carrier.  “The medical expert providing an impairment rating should always indicate how it was calculated. For example, the medical expert should specify which chapter, table and page and/or other specific criteria from the Guides were followed in arriving at the rating. If no explanation is provided, the adjuster should request more specific information from the medical expert.”  https://labor.vermont.gov/sites/labor/files/doc_library/Part%204-indemnity-benefits-adjusters-manual.pdf  accessed on 1/19/2023

“You are entitled to mileage reimbursement if you are required to travel for medical treatment or examination and/or vocational rehabilitation-related counseling or assessment. Mileage reimbursement rates are set annually and are available on our website. Keep a written record of mileage traveled to and from all appointments.”  From the Vermont Department of Labor  https://labor.vermont.gov/sites/labor/files/doc_library/Work%20Injuries%20brochure_0.pdf Accessed on 1/19/2023

“Reinstatement laws only apply to employers with 10 or more employees. You must keep your employer informed of your medical (and return to work) status, your contact information and your continued interest in re-employment. Provided you are able to return to work within two years from the date you became unable to work, your employer is obligated to offer you the next available suitable position. However, the employer is not obligated to fire the person who replaced you in order to create a place for you.” From the Vermont Department of Labor  https://labor.vermont.gov/sites/labor/files/doc_library/Work%20Injuries%20brochure_0.pdf Accessed on 1/19/2023

“If you are released to return to work without restrictions, either full or part-time, immediately notify your employer and make arrangements with your employer to return to work immediately or as soon as possible. If your doctor releases you to return to work with restrictions, you should contact your employer immediately to see if it has suitable work available. You are obligated to return to work if a suitable job is offered. If your employer does not have suitable work available, you should begin looking for work within your restrictions, and you must document your job search eff orts. A job search log is available on our website. If you are unable to return to work for which you have previous training or experience, or if you have been on workers’ comp for more than 90 days, you may be entitled to vocational rehabilitation services.”  From the Vermont Department of Labor https://labor.vermont.gov/sites/labor/files/doc_library/Work%20Injuries%20brochure_0.pdf Accessed on 1/19/2023

Per the Vermont Department of Labor: “The primary objective of vocational rehabilitation is the restoration of the injured worker to suitable work.  Vermont Statute 21 VSA §641 requires employers to provide vocational rehabilitation services to any injured worker when, they are unable to return to suitable employment because of their work injury.  It is the responsibility of each employer or adjuster to initiate the vocational rehabilitation process.  Vocational Rehabilitation (VR) refers to the services and benefits that can assist an injured worker in returning to suitable work.” https://labor.vermont.gov/workers%E2%80%99-compensation/injured-workers/voc-rehab-information-injured-workers  Accessed on 1/19/2023

“An Independent Medical Examination (IME) is a medical exam arranged by the insurance company with a doctor of its choice. The purpose of the IME is to provide the insurance company with a review of whatever medical conditions have arisen as a result of your work injury. This review might include such issues as the appropriate treatment for your injury, your work capacity, or the extent, if any, of your permanent impairment. You must be given at least seven days’ written notice of the examination date, and if you have a scheduling conflict YOU MUST NOTIFY the insurance adjuster immediately so that the IME can be rescheduled. If you fail to attend the IME without good cause, your benefits might be suspended.”  From the Vermont Department of Labor  https://labor.vermont.gov/sites/labor/files/doc_library/Work%20Injuries%20brochure_0.pdf  Accessed on 1/19/2023

A physician experienced in Occupational Medicine and trained/experienced in the use of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th Edition.

If you are injured on the job you may be entitled to one or more of these benefits: 

Medical benefits: You are entitled to payment for medical care, medicines and supplies that are reasonable and necessary for your injury. These may include doctor visits, hospital care, physical therapy, chiropractic treatment, and counseling.

Wage replacement benefits: If you are unable to work for four or more days as a result of your injury, you may be entitled to temporary total disability (TTD) benefits. You also will receive an additional $10 per week for each of your dependents. If your doctor releases you to part-time work, you may receive temporary partial disability (TPD) benefits for your lost wages. Once you either conclude treatment or successfully return to work, your entitlement to wage replacement benefits ends. 

Permanent partial disability (PPD) benefits: These are not wage replacement benefits or a “settlement” of the claim. PPD is a limited monetary benefit intended to compensate for any permanent loss of function you are found to have suffered as a result of the work injury. Not all injuries result in permanent impairment. 

Permanent total disability (PTD) benefits: These are weekly benefits that are paid if it is determined that you are permanently unable to return to any regular gainful employment as a result of your work injury. 

Vocational rehabilitation benefits: If your injury prevents you from returning to employment for which you have previous training or experience, you may be entitled to vocational rehabilitation benefits. These may include job placement, on-the-job training, or other assistance to help you return to suitable employment. 

Death benefits: These are weekly benefits that are provided to a worker’s spouse and/or dependents if the worker dies from a work-related injury.

From the Vermont Department of Labor  https://labor.vermont.gov/sites/labor/files/doc_library/Work%20Injuries%20brochure_0.pdf Accessed on 1/19/2023

NO. The AMA Guides 5th edition requires an in-person evaluation.  

From the Vermont Department of Labor  https://labor.vermont.gov/sites/labor/files/doc_library/determining%20medical%20end%20and%20rating%20impairment%20during%20and%20post%20covid.docx.pdf Accessed on 1/19/2023

No. The AMA Guides 5th edition requires in-person evaluation.   

From the Vermont Department of Labor  https://labor.vermont.gov/sites/labor/files/doc_library/determining%20medical%20end%20and%20rating%20impairment%20during%20and%20post%20covid.docx.pdf Accessed on 1/19/2023

A physician who is licensed in the state in which the IME occurs and who is in active clinical practice in the specialty area in which the opinions of the IME are requested.