Med-Legal, LLC. Permanent Disability Med-Legal, LLC

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1 Permanent Disability % Weeks % Weeks $69. $ $64,227.5 $8, $,38. $, $66,67.5 $83, $2,7. $2, $67,97.5 $85, $2,76. $3, $69,747.5 $87, $3,45. $4, $84,37.5 $9, $4,4. $5, $86,97.5 $92, $4,83. $6, $88,357.5 $94, $5,52. $6, $9,57.5 $97, $6,2. $7, $92,677.5 $99, $6,957.5 $8, $94,837.5 $, $7,877.5 $9, $96,997.5 $4, $8,797.5 $, $99,57.5 $6, $9,77.5 $2, $,37.5 $8, $,637.5 $3, $3,477.5 $, $,65. $4, $5,637.5 $3, $2,765. $6, $7,797.5 $5, $3,95. $7, $9,957.5 $8, $5,65. $8, $2,7.5 $2, $6,25. $2, $4,277.5 $22, $7,365. $2, $25,642.5 $25, $8,55. $23, $3,282.5 $3, $9,665. $24, $34,922.5 $34, $2,85. $26, $39,562.5 $39, $2,965. $27, $44,22.5 $44, $23,72.5 $29, $48,842.5 $48, $24,552.5 $3, $53,482.5 $53, $25,932.5 $32, $58,22.5 $58, $27,32.5 $34, $62,762.5 $62, $28,692.5 $36, $67,42.5 $67, $3,3. $37, $72,42.5 $72, $3,74. $4, $76,682.5 $76, $33,35. $42, $8,322.5 $8, $34,96. $44, $85,962.5 $85, $36,57. $46, $9,62.5 $9, $38,8. $48, $95,242.5 $95, $39,79. $5, $99,882.5 $99, $4,4. $52, $24,522.5 $24, $43,. $54, $29,62.5 $29, $44,62. $56, $23,82.5 $23, $46,23. $58, $28,442.5 $28, $47,84. $6, $223,82.5 $223, $49,45. $62, $227,722.5 $227, $5,6. $64, $232,362.5 $232, $52,67. $66, $237,2.5 $237, $54,28. $68, $24,642.5 $24, $55,89. $7, $246,282.5 $246, $57,5. $72, $25,922.5 $25, $59,. $74, $255,562.5 $255, $6,72. $76, $26,22.5 $26, $62,387.5 $78,662.5 Med-Legal, LLC 27 Med-Legal, LLC

2 Permanent Disability % Weeks through 22 +5% -5% * +5% -5% * ,32.,32.,22.,38.,38., ,98.,994.4,683. 2,7. 2,84.79, ,64. 2, ,244. 2,76. 2, , ,3. 3,52.4 2,85. 3,45. 3, , ,96. 4,27.4 3,366. 4,4. 4, , ,62. 5,3.4 3,927. 4,83. 5, , ,28. 5, ,488. 5,52. 6, , ,94. 6, ,49. 6,2. 6, , ,655. 7, , , ,75.4 5, ,535. 8, , , , , ,45. 9, , , ,82.4 7, ,295., ,9.75 9,77.5, , ,75., ,648.75,637.5, , ,. 2, ,443.5,65. 3,6.54 9, ,2. 3,758.64, ,765. 4,384.4, ,3. 5,23.64,33.5 3,95. 5,76.54, ,4. 6, , ,65. 7,29.4 2, ,5. 7, ,83.5 6,25. 8, , ,6. 8, ,8.5 7,365. 9, , ,7. 2, ,53.5 8,55. 2, , ,8. 2, , , ,39.4 6, ,9. 22, , ,85. 23, , ,. 23, , , , , ,65. 25, , , , , , , , , , , ,85. 28, , , , , ,25. 29, , ,32.5 3, , ,445. 3, , , , , ,82. 32, ,497. 3,3. 34, , ,36. 34, ,86. 3,74. 36, , ,9. 36, ,5. 33,35. 38, , ,44. 38, , ,96. 39, , ,98. 39, , ,57. 4, , ,52. 4,75.4 3,42. 38,8. 43, , ,6. 43, ,35. 39,79. 45, , ,6. 45, ,66. 4,4. 47, , ,4. 47, , ,. 49, , ,68. 48, , ,62. 5, , ,22. 5, , ,23. 52, , ,76. 52, , ,84. 54, , ,3. 54,2.4 4,25. 49,45. 56, , ,84. 55, ,54. 5,6. 58, , ,38. 57, , ,67. 6, , ,92. 59, ,32. 54,28. 62, , ,46. 6, ,44. 55,89. 63, , ,. 62, ,75. 57,5. 65, , ,54. 64, ,59. 59,. 67, , ,8. 66, ,368. 6,72. 69, , , , , , , ,29.38 Med-Legal, LLC 2 27 Med-Legal, LLC

3 Permanent Disability % Weeks through 22 +5% -5% * +5% -5% * ,435. 7, , , , , ,95. 72, , , , , , , , , , , ,75. 76, , , , , , , , , ,29.9 6, ,235. 8, , , , , , ,5.39 6, , , , , , , ,7.5 88, , ,55. 86, , , , , , , , , , , ,35. 9, , , , , , , , , ,84.9 7, , , , , , , ,35. 96, , ,47.5, , ,75. 98, , , , , ,835., , , , , ,595. 2, , , , , ,355. 4, , ,57.5 9, , ,5. 6, , ,347.5, , , , , , , , , , ,2.88 2, , , , ,2.98 6, , ,2.98 6, , ,8.98, , ,8.98, , , , , , , , ,6.98 7, , ,6.98 7, , , , , , , , , , , , , , , , , , , , , , , , , , , ,5.88 6, , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,5.88 8, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,98.88 Med-Legal, LLC 3 27 Med-Legal, LLC

4 % Weeks //96 to 2/3/2 23 Permanent Disability Weeks ,. 8., ,26., , ,68. 2, , ,. 2, , ,52. 3, , ,94. 3, , ,36. 4, , ,78. 4, , ,235. 5, , ,795. 6, , ,355. 7, , ,95. 7, , ,475. 8, , ,4. 9, , ,68., , ,32., , ,96., , ,6. 2, , ,28. 3, , ,8. 3, , ,88. 4, , ,68. 5, , ,48. 6, , , , , , , , ,37.5 9, , , , , , , , ,42. 23, , ,6. 24, , ,8. 25, , ,99. 27, , ,8. 28, , ,37. 29, , ,56. 3, , ,75. 32, , ,94. 33, , ,3. 34, , ,32. 36, , ,5. 37, , ,7. 38, , ,89. 4, , ,8. 4, , ,27. 42, , ,46. 44, , ,65. 45, , ,84. 46, , ,3. 47, , , , ,2. % 24 Weeks //96 to Weeks 23 2/3/ , , , , , , , , , , , , , , , , , , , , , ,42.5 6, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,2.5 77, , ,95. 98, , ,65., , ,235. 2, , ,35. 4, , ,375. 6, , ,445. 8, , ,55., , ,585. 2, , ,655. 4, , ,725. 6, , ,795. 8, , ,865. 2, , , , , ,5. 25, , ,75. 27, , ,45. 29, , ,25. 3, , , , , , , , , , , , , , ,565. 4, , , , , ,75. 45, , , , , , , , ,95. 5, , , , , ,55. 56, , ,25. 58, , Med-Legal, LLC

5 Permanent Partial Disability Weekly Rate Date of Injury Percentage Minimum Maximum (on or after) Disability Earnings Rate Earnings Rate //84 : //9 : : //94 : : : : //95 : : : : //96 : : : : //3 : : //4 : : // // // // is not increased by SAWW LC 4453(b) 2. Permanent disability weekly payments are paid at 2/3 of weekly earnings -- not to exceed the above maximum rate and must be at least the minimum rate. 3. Permanent disability weekly payments are paid for the number of week specified in the first table based upon the percentage rating. Useful Links Judicial opinions TPA list Labor code EDD ml QME Regs EEOC WCAB Rules of Practice & Procedure Medical Treatment Utilization Schedule Schedule for Rating Perm Disability 25 SB863 CAAA Records Order Form State bar WCAB decisions CIGA Case Lookup Forms WCAB Self-insured EAMS UANs LC/EAMSClaimsAdmins.asp list Carve-out WCIRB Rating & present value Med-Legal, LLC

6 % Date of Injury (on or after) Life Pension % 7//94 7//95 7//96 //3 // When the permanent disability is 7 % or greater, life pension weekly payments are made at the above rate, depending the percentage of disability. Formula: Life pension = ( % - 6 ) x.5 x (Weekly Earnings within maximum, table immediately above) LC There have been no increases in maximum weekly earnings since // Date life pension payments start is not reflected in the above tables because life pension payments do not commence until permanent partial payments end. For a date of injury in 23 with a permanent partial disability of 7% life pension payments would not start until weeks after the permanent and stationary date. Payments would not begin until 8.7 years after the P&S date. 4. For DOI on or after //23 the rate of payment is not known until the start of payments due to COLA increases. COLA increases commence on Jan after the start of the life pension. 5. For injuries occurring on or after January, 23, an employee who becomes entitled to receive a life pension or total permanent disability indemnity shall have that payment increased annually commencing on January, 24, and each January thereafter, by an amount LC 4659(c) Injury Date (on or after) Weekly Earnings Maximum // // // // // // Supplemental Job Displacement Benefit Voucher P Award Voucher Amount Less than 5% Up to $4, Between 5% and 25% Up to $6, Between 26% and 49% Up to $8, Between 5% and 99% Up to $, For injuries before //3 the amount of the voucher for the supplemental job displacement benefit will be as follows: Voucher expires in two years or 5 years from date of injury. On or after //3 voucher is $6,. LC Mileage Reimbursement Rates for Medical and Med-Legal Incurred in year Cents per mile 26 July July July Med-Legal, LLC

7 Temporary Total Disability (TTD) and Permanent Total Disability Year SAWW Earnings , , , , , ,64.5 Min 89. Max 26. Min 89. Max 26. Min Max Min 26.8 Max Min Max Min 222. Max 48.4 Min 222. Max 48.4 Min Max Min 24. Max 6.8 Min Max 6.96 Min Max Min Max Min TTD Payment Aggregate disability payments for a single injury occurring on or after 4/9/4 shall not extend for more than 4 compensable weeks within a period of two years from the date of commencement of TTD. Aggregate disability payments for a single injury occurring on or after //28 shall not extend for more than 4 compensable weeks within a period of five years from the date of commencement of TTD. 2. Certain acute or severe disabilities* extend for 24 weeks. LC TTD payments made two or more years from the date of injury are made at the rate in effect on the date each payment is made. LC For injuries occurring on or after //5 commencing //7 the limits are increased annually by percentage increase of State Average Weekly Wage (SAWW). LC 4453(a)() 5. Temporary disability payments are paid at 2/3 of the weekly earnings within the limits specified in the above table. LC 4653 Acute and Chronic hepatitis B and C; amputations, severe burns, HIV, highvelocity eye injuries; chemical burns to eyes; pulmonary fibrosis; chronic lung disease Life Expectancy US Life Tables 28 Max Age All Male Female Age All Male Female Age All Male Female Over Med-Legal, LLC

8 Death Benefits Date of Injury (on or after) //84 //9 7//94 7//96 //6 Dependents Total Partial 2 or more or more or more 2 or more or more or more 2 3 or more or more or more 2 3 or more or more or more 2 3 or more or more or more Benefit Maximum 7, 95, 7, + 4 x annual support but not more than 95, 4 x annual support but no more than 7, 95, 5, 95, + 4 x annual support but not more than 5, 4 x annual support but not more than 95, 5, 35, 5, 5, + 4 x annual support but not more than 25, 4 x annual support but not more than 5, 25, 45, 6, 25, + 4 x annual support but not more than 45, 4 x annual support but not more than 25, 25, 29, 32, 25, + 4 x annual support but not more than 29, 8 x annual support but not more than 25,. 2. Death benefits LC 472(a). Death benefits are determined at the date of injury not date of death. Death benefits are paid in payments at the same rate as temporary total disability unless otherwise ordered by WCAB except the minimum payment is $224. per week. LC 472(b) 3. Rate of payment is the rate in effect at the date of injury and remains that rate for the first two years following the date of injury. After two years from the date of injury any payments are increased to the temporary total disability rate currently in effect at the date of payment. LC Temporary total disability maximum and minimum are increased yearly by SAWW. If the date of injury is in 27 the payment rate is 2/3 AWW up to maximum of $ If the date of injury is in 28 the maximum rate is $ LC 4453(a)() Payments below maximum and above $224. are not increased yearly by a COLA. 5. Payments will be the same for the first two years after date of injury then if 2/3 of weekly wage is above maximum the payment will increase to the maximum. Payment rate will continue to increase each year until 2/3 of weekly wage is below the maximum, and then the payment rate will be constant at 2/3 of weekly wage. 6. Where there is one or more totally dependent minor children, payments shall continue after the benefit is paid until the youngest child attains the age of 8 or until the death of a child physically or mentally incapacitated from earnings. LC Maximum burial expense //9 2/3/2 $5,; on or after //3 $,. LC Dependents conclusively presumed wholly dependent: () minor child or a child of any age found to be physically or mentally incapacitated from earning who was either living with deceased parent or the deceased parent is legally liable at the time of injury; (2) Spouse earning less than $3, in the preceding 2 months at time of death. 9. Where there are two or more total dependents there is no increase for partial dependents.. If there are no total dependents and one or more partial dependents, the partial dependents share in accordance with their relative extent of dependency.. Temporary or permanent disability payments, if any, stop at death. Accrued and unpaid compensation is paid to the dependents. Accrued disability compensation is in addition to death benefits if the employment injury contributed to or caused the death. LC The period within which to commence proceedings for the collection of death benefits is one year from death where death occurs within one year of DOI; or one year from date of last furnishing of any benefits or one year from death where death occurs more than one year from DOI. No such proceedings may be commenced more than 24 weeks from the date of injury. LC Med-Legal, LLC