Hi All, I first want to say what an AWSOME site this is! Reading the different threads has answered more of my questions then any other site!!
I was injured on 10/03/05, diagnosed with a complete rotor cuff tear on the right shoulder and told only surgery could repair it properly. During the recovery period the doctor discovered the cuff was in need of more repair and also recommended a tenodesis procedure as well. The insurance carrier (Idaho State Insurance Fund) sent me to another DR. (for a IME) and Per their request, the IME doctor issued a 15% PPI and a 25lb weight restriction But, would not deem me stable until after viewing the ordered MRI, then agreed with my doctors findings and recomended the surgery.
The second surgery was performed 2 weeks ago on 9/13/06 and now I am starting all over again with the loooooong recovery process.
There was never any doubt about how the injury occured and I have been receiving Total Temporary Disability payments (TTD) since the day of the accident. The Insurance has been paying every associated cost and sends me a check within days of receiving a milage report of medical appointments so consulting an attorney has never been an issue. I also know that once the doctor says I am at Maximum Medical Improvement (MMI),and issues a Permenant Partial Impairment (PPI), the TTD stops and
the PPI starts based on the schedule set out by law.
Both of the doctors have stated I will never be able to return to my position as a concreate form setter due to the heavy and overhead lifting requirements and my employer has since filled my position.
My question is this:
At MMI, If my work market diminishes to Medium/Light work with obviously less starting pay will the insurer add PPD or do ALL cases have to fight or litigate to get that benifit considered (which is over and obove PPI based on non- medical factors such as diminished working market.
Thank you for any advice you can offer, Tim