Practice Pointer: Rating Impairment for Radiculopathy

The presence or absence of radiculopathy is often critical to calculating an accurate impairment rating in low back injury cases. For radiculopathy to be ratable, however, there must be more than simply a report diagnosing the condition.

In Texas Division of Workers’ Compensation Appeals Panel Decision No. 150283, the Appeals Panel reversed the decision of a Hearing Officer and remanded the case for further consideration. The Appeals Panel observed that the Hearing Officer had adopted an impairment rating, a component of which included radiculopathy, even though no doctor had documented any significant signs of radiculopathy to rate radiculopathy under The AMA Guides.

Relying upon Texas Division of Workers’ Compensation Appeals Panel Decision No. 072220-s, decided February 5, 2008, the Appeals Panel held that to receive a rating for radiculopathy the claimant must have significant signs of radiculopathy, such as loss of relevant reflexes, or measured unilateral atrophy of 2 cm or more above or below the knee, compared to measurements on the contralateral side at the same location.

The Appeals Panel has long held that The AMA Guides do not require a total loss of reflexes to qualify for an impairment rating based on the presence of radiculopathy. Texas Division of Workers’ Compensation Appeals Panel Decision No. 111710.

Where the claimant’s examination does not demonstrate “significant signs of radiculopathy, such as loss of relevant reflexes, or measured unilateral atrophy of 2 cm or more above or below the knee, compared to measurements on the contralateral side at the same location” an increase in the impairment rating based upon radiculopathy is not warranted.