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ame report

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Latest post Sun, May 11 2008 8:43 PM by stevepsca. 4 replies.
  • Sat, May 10 2008 8:47 PM

    ame report

    Hi again, I finally rec. my ame report, the dr. stated i had a 12percent whole person impairment.
    also said i had reached pand s status. my question is this, How come state comp is not sending me payments? Is 12 percent good or bad for me?
    My attn, had sent a request for consultative rating to dis.evaulator. what can i expect now? the ame
    said i was 40 percent before and 60 percent due to accident at work. also said i needed further medical and had perm. work restrictions. any help would be greatly appreciated my attn. tells me nota.
  • Sat, May 10 2008 11:46 PM In reply to

    re: ame report

    you're entitled to advances on your permanent disability. the maximum rate is lower then for TD. Maybe there is an overpayment or they have already advanced enough. Have your atty find out.
    If the delay is beyond 14 days have your atty file for a penalty.
    Expect the rating to be modified for your age, occupation, and future earning capacity.
  • Sun, May 11 2008 12:53 PM In reply to

    Feedback [*=*] re: ame report

    You may not be receiving PDA's because of the request for rating from the DEU, but SCIF should send you a NOPE letter and explain WHY they are not paying benefits...
    PDA's are paid at around $230/wk.

    NOPE is "Notice of Potential Eligibility (of benefits)''

    The 12% WPI is a 'final' rating, allowing for your age, earning capacity etc, and that is the rating your award will be based on... unless the DEU comes back with somthing different.
    A PD rating is converted to a WPI or Whole Person Impairment rating.

    When you AME said ''60% is work related'', that means that 40% is due to 'other factors' that are cause for your PD...which final rating is reduced by 40% to apportionment....the ER/IC is only liable for the % of PD directly attributable to your injury.

    As you are now P&S/MMI your ER should be sending/making you a valid RTW offer...and/or engaging in the 'interactive process'...this is a face to face meeting between you and your ER to determine IF they can make a 'reasonable acommodation' to bring you back to work.

    The labor code defines a 'valid job offer' and what it should consist can read about this in section 4658(2) and 4658.1 here

    Any settlement offer you might receive will be based on your WPI rating, and the SWAG/Scientific Wild Ass Guess of the value of your future medical as determined by your PTP/AME.
  • Sun, May 11 2008 5:19 PM In reply to

    Feedback [*=*] re: ame report

    The 12% WPI will be modified according to various factors including your age and occupation. the result will be your permanent disability percentage which will then be reduced (apportioned) by 40%.

    The good news is that your present and future medical is not be subject to the 40% reduction.
  • Sun, May 11 2008 8:43 PM In reply to

    More [=+=] re: ame report

    You can read about how PD/WPI ratings are done here...

    The labor code also provides inforamtion/statute that governs PD/WPI ratings...
    4660. (a) In determining the percentages of permanent disability,
    account shall be taken of the nature of the physical injury or
    disfigurement, the occupation of the injured employee, and his or her
    age at the time of the injury, consideration being given to an
    employee's diminished future earning capacity.
    (b) (1) For purposes of this section, the "nature of the physical
    injury or disfigurement" shall incorporate the descriptions and
    measurements of physical impairments and the corresponding
    percentages of impairments published in the American Medical
    Association (AMA) Guides to the Evaluation of Permanent Impairment
    (5th Edition).
    (2) For purposes of this section, an employee's diminished future
    earning capacity shall be a numeric formula based on empirical data
    and findings that aggregate the average percentage of long-term loss
    of income resulting from each type of injury for similarly situated
    employees. The administrative director shall formulate the adjusted
    rating schedule based on empirical data and findings from the
    Evaluation of California's Permanent Disability Rating Schedule,
    Interim Report (December 2003), prepared by the RAND Institute for
    Civil Justice, and upon data from additional empirical studies.
    (c) The administrative director shall amend the schedule for the
    determination of the percentage of permanent disability in accordance
    with this section at least once every five years. This schedule
    shall be available for public inspection and, without formal
    introduction in evidence, shall be prima facie evidence of the
    percentage of permanent disability to be attributed to each injury
    covered by the schedule.
    (d) The schedule shall promote consistency, uniformity, and
    objectivity. The schedule and any amendment thereto or revision
    thereof shall apply prospectively and shall apply to and govern only
    those permanent disabilities that result from compensable injuries
    received or occurring on and after the effective date of the adoption
    of the schedule, amendment or revision, as the fact may be. For
    compensable claims arising before January 1, 2005, the schedule as
    revised pursuant to changes made in legislation enacted during the
    2003-04 Regular and Extraordinary Sessions shall apply to the
    determination of permanent disabilities when there has been either no
    comprehensive medical-legal report or no report by a treating
    physician indicating the existence of permanent disability, or when
    the employer is not required to provide the notice required by
    Section 4061 to the injured worker.
    (e) On or before January 1, 2005, the administrative director
    shall adopt regulations to implement the changes made to this section
    by the act that added this subdivision.

    Once your PTP/AME calculates a PD rating that rating/number will be converted to a WPI rating and that will be the basis for your ''award'' for PD indemnity...

    The 12% is worth 5 weeks for each 1% of the rating..or 60 weeks, payable at around $230/wk or $13,800 give or take 15% depending on the factors of your case.

    Recent decisions on case review/appeal and actions taken by the legislature have resulted in some potential changes in the PDRS..while this may or may not affect your case, you can read this blog ... and see what's happening in the WC arena.
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