140 PERMANENT DISABILITY

140.1 A claimant may be eligible for permanent disability indemnity compensation upon:

(a) Reaching maximum medical improvement (MMI) for a disability and temporary disability compensation has ceased;

(b) Receiving four hundred-forty-eight (448) weeks of temporary total or partial disability; or

(c) Loss of use of both hands, both arms, both feet, or both legs, or the loss of sight of both eyes.

140.2 Claims for permanent disability by claimants, who are eligible to request an award pursuant to § 140.1(a) of this chapter shall, be filed with the Program:

(a) Within one hundred and eighty (180) days of the termination of temporary disability indemnity benefits by the Program. Claimants who fail to request an award within one hundred and eighty (180) days of termination of temporary disability indemnity benefits shall not be entitled to permanent disability indemnity benefits thereafter, unless there is good cause to excuse the delay; or

(b) At any time after the claimant has been determined to have reached MMI and to have a permanent impairment involving the loss of use of a member or function of the body, or disfigurement.

140.3 Claims for permanent disability by claimants, who are eligible to request an award pursuant to § 140.1(b) of this chapter shall be filed as a hearing for permanent disability with the Office of Administrative Hearings within fifty-two (52) weeks after receipt of the 448th week of temporary total or partial disability indemnity benefits. Claimants who fail to request a hearing within the last fifty-two (52) weeks of five hundred (500) weeks of benefits shall not be entitled to permanent temporary or partial disability indemnity benefits thereafter.

140.4 A claimant eligible for permanent disability pursuant to § 140.1(c) of this chapter may be awarded a scheduled award for permanent disability in lieu of temporary disability upon filing a claim for indemnity compensation.

140.5 To file a claim for permanent disability under Section 2307 of the Act, the claimant shall complete Form 12 and provide supporting information and documentation, including a permanent disability rating performed in accordance to the most recent edition of the AMA Guides from a qualified physician.

140.6 If a claimant requests a schedule award pursuant to § 140.1(a) of this chapter, the Program shall:- (a) Review the request;

- (b) Request additional information or action as necessary, including the scheduling of a physical examination(s), to evaluate the extent of permanency; and

- (c) Issue a written decision within thirty (30) days of receipt of all required documents that shall:

- (1) Sets forth the basis for accepting or denying the request; and

- (2) Be accompanied by information about the claimant's right to appeal the Program's decision to the Chief Risk Officer, as provided in § 156 of this chapter.140.7 Initial awards for permanent disability compensation shall be computed pursuant to § 129 of this chapter and in accordance with the schedule provided at Section 2307 of the Act and shall not be subject to cost-of-living-adjustments. Adjustments to this rate shall be made pursuant to Section 2341, as they become available.140.8 Permanent partial disability shall be computed by:- (a) Calculating the monthly compensation less COLAS pursuant to § 129 of this chapter;

- (b) Converting the monthly compensation to weekly compensation by multiplying the monthly compensation rate by twelve (12) and dividing the product by fifty-two (52);

- (c) The adjusted award schedule for partial disability shall be computed by multiplying the total number of weeks available for the impairment member under Section 2307(c) of the Act by the percentage impairment rating provided by the physician; and

- (d) The total award for partial disability shall be computed by multiplying the adjusted award schedule for partial disability by the weekly compensation rate computed pursuant to § 140.8(b).140.9 Medical reports establishing eligibility and determination for schedule awards

under Section 2307 of the Act shall be prepared by physicians with specific training and experience in the use of the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment.

140.10 A claimant who requests or receives a schedule award pursuant to Section 2307 of the Act is ineligible for further indemnity payment(s) for temporary disability arising out of the same injury for which a schedule award has been approved or paid.

140.11 A claimant may not receive indemnity compensation for temporary disability and a schedule award at the same time.

SOURCE: Final Rulemaking published at 28 DCR 2307 (May 22, 1981); as amended by Emergency and Proposed Rulemaking published at 57 DCR 9540 (October 8, 2010)[EXPIRED]; as amended by Final Rulemaking published at 57 DCR 12224, 12229 (December 24, 2010); as amended by Final Rulemaking published at 59 DCR 8766, 8771 (July 27, 2012); as amended by Final Rulemaking published at 64 DCR 6325 (July 7, 2017).