I went back to the Designated Doctor last week, and received the letter yesterday with the box checked for a permanent imparment but an impairment rating of 0%.

What exactly does this mean?

I've already been forced back to work against my doctor's orders. I was told by my employer if I wasn't back at work my contract wouldn't be renewed next year, and as a teacher we only sign one year contracts in the state of Texas. This is also not a good time to be looking for a teaching job in my state since they are laying in teachers by the 1000's.

I'm trying to find coping mechanisms to get through my daily life, but the headaches just seem to be getting worse now that I am back in the classroom. I also seem to be holding my stress and tension in my neck, which makes the headaches worse.

I am currently taking 100 mg of Topomax, and I have prescriptions for 5mg of Ativan, 5 mg of Ambien, Treximet and a muscle relaxer (parafon forte) that are all taken as necessary. I don't like taking medications so I typically don't take the last 4 very often.

I am also going to a Chiropracter twice a week for adjustents to try and get my neck back in line from the fall. I felt relief after the first week, but the second week my doctor added in PT with stretches for my neck and I felt like I took 2 steps back. I have had a headache since Thursday with the culmination last night.

I layed in bed crying due to the pain from the headache after trying heat, cold, massage, bath, shower, pain patch, silence, dark, light music, and a combination of my medications. I had blurry vision, ringing in ears, and just felt completely lethargic. After finally falling asleep for a few hours I woke up this morning and the headache is slightly better, but definitely still there.

This leads me back to the original question of how do I get an impairment rating of 0% while I am still experiencing this much pain. It has been 9 months now since the original injury and I really felt like I was starting to see some small improvements in some aspects of my life. It is so frustrating when I take steps back!

Three days ago I was feeling better and made the terrible decision to drive to a museum 1 hour away. I saw it as a test to see where I was at. Snapping pictures and slowly checking things out I felt fatigue coming on and left for home.

That night I couldn't sleep due to a brand new symptom - every time my mind would get tired and begin to drift off into sleep-world my brain wouldn't allow it. I'd be forced to wake up from these crazy intense swirling/dizzy/head-rush sensations.

These symptoms have since dissipated. But as you said, it is so frustrating to have these set backs. I now feel as I did just weeks after my fall. My worst symptom is the dizziness/unsteadiness and fogginess.

Hang in there! I'm sure things will get better. I recently met two friends of friends that delt with severe PCS for over a year and the other just a few months and both are now right back to normal life. They told me that time and rest were the best healers.

You need to find out about the back to work issue call the dr and safe for you or not..You could be jeopardizing your health- or even from a legal standpoint if you return to work against the drs written restrictions (off work).
as well as contact the dr about the rating to see if it is a typo or what that is all about.

I thought the teachers unions are supposed to help in some of these situations.

Unfortunately it is not a typo...according to the determination paperwork that was included with the report, "Head contusion with LOC with residual headaches yields a 0% whole person impairment." I'm not sure how it can be determined that I have a permanent impairment, but 0% impairment. I guess that just means the state acknowledges that I was injured and I have symptoms, but I am not going to get any better and I will just have to live with it.

As far as my work situation goes neither my neurologist or the designated doctor had released me when I was threatened, but since I have not been back and work and seem to be "handling" it both doctors now feel being around the positive attitudes of my children will help my recovery. I made the mistake by going back to work and being scared by the threats.

I have tried to find a workers comp attorney in Texas, but that has been difficult since was out on assault leave they would not get paid, and now that I have an impairment rating of 0% there is no way for them to get a settlement of any kind so none of them will take my case.

I have been told to contact an employment attorney, which I have done and I have been told there might be a possibility of a small settlement but I would then never be able to find a job as a teacher again because no one would touch me. Most lawyers don't want to take on school districts to begin with and they don't understand PCS and head injuries.

It is almost as difficult to find doctors who understand what I am dealing with. Last week after sitting in my chiropractor/PT office for over an hour with multiple conversations, TV, PT machines, music, and doors opening and closing I felt like my head was about to explode.

When I was finally moved to a room to try and give me some quiet my doctor accused me of having a panic attic and told me to get help with this since he could not help me with panic attacks. This was the first time this doctor hadn't even asked what was going on and jumped straight to the conclusion of a panic attack.

I understand most people aren't educated in PCS and they don't understand what we are going through or what triggers our symptoms, but to not even ask me as my doctor really upset and frustrated me. It was very concerning that he didn't even seem to want to learn or be educated, but jump straight to the a panic attack diagnosis.

Sorry to have gone off on a rant...

Hmmm, seems like a good chiro would educate himself about head injuries...
You might be beyond his level of training now and he doesn't care to educate himself about it.

no help from teachers union?

the wc attys here get a % of the settlement - the injured person doesn't have to pay outright.

I mean if you have a relapse and need more care - is your pvt medical going to pay, who's been paying for treatment so far?

comp or pvt ins?

Unfortunately, my union has not been very helpful thus far. Texas is a right to work state and unions don't carry very much weight.

The WC will not get paid because their won't be a settlement with an impairment rating of 0%.

Thus far WC has been paying for my treatment, but I have ben paying for my medications and last month I started going to my own GP just to make sure the WC doctor was really looking out for my best interest.

Thanks for your comments!

Is there an appeals process for the doctor's 0% rating?

It sounds like you have a WC system similar to the WC system in California. WC has never been for the benefit of the employee. It is federally mandated but protects the employer from personal injury law suits.

The limit on attorney's fees limits the access to attorneys. In California, the employee can not even pay the attorney from his own funds. As a result, the only recourse is for the employee to self represent in the process.

Send me a PM and I can speak more directly to these issues. Some do not need to be discussed on a public forum.

I was in the same situation. My disability was recognized by not attributed to the work place injury. If you look further in the report, was there any mention of other causation?

Congresswoman Gabrielle Gifford's office is pushing for federal WC rules to support the head injured patient. Maybe there is some help you can get from your Congress Critter. The way state systems deny the claims of head injured patients is abominable. I usually say, keep the feds out, but in this case, the feds started the WC system and it is broken and needs fixing.