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

(a) Reaching maximum medical improvement (MMI) for a disability;

(b) Receiving four hundred-forty-eight (448) weeks of temporary total or partial disability wage-loss compensation; 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 A claim for permanent disability compensation by a claimant who is 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 after the termination of temporary disability wage-loss benefits by the Program where the claimant has reached MMI. A claimant who fails to file a claim for permanent disability within one hundred and eighty (180) days after termination of temporary disability wage-loss benefits shall not be entitled to permanent disability benefits thereafter, unless there is good cause found by the Program 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, subject to limitations provided at Section 2321 of the Act (D.C. Official Code § 1-623.21).

140.3 A claim for permanent disability compensation by a claimant who is 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 four hundred forty-eighth (448th) week of temporary total or partial disability wage-loss benefits. A claimant who fails to request a hearing within the last fifty-two (52) weeks of five hundred (500) weeks of benefits shall not be entitled to permanent disability benefits.

140.4 A claimant who is eligible to receive permanent disability compensation pursuant to § 140.1(c) of this chapter may be awarded a scheduled award for permanent disability in lieu of temporary disability wage-loss benefits upon filing a claim for temporary total disability wage-loss compensation.

140.5 To file a claim for permanent disability compensation under Section 2307 of the Act (D.C. Official Code § 1-623.07), the claimant shall complete Form 12 and

provide supporting information and documentation, including a permanent disability rating performed in accordance with the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides) from a qualified physician, if a permanent disability rating has already been provided to the claimant by the treating physician. If a permanent disability rating has not been provided, the claimant may request authorization to obtain an impairment rating on Form 12 and the Program will designate a physician to evaluate the claimant accordingly.

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 A medical report submitted to the Program in support of a determination of eligibility for a schedule award under Section 2307 of the Act (D.C. Official Code § 1-623.07) shall be prepared by a physician with specific training and experience in the use of the most recent edition of the AMA Guides. The medical report must identify the specific page number, paragraph, and table relied upon within the AMA Guides to establish where and how the physician arrived at the impairment rating.

140.10 A claimant who requests or receives a schedule award pursuant to Section 2307 of the Act (D.C. Official Code § 1-623.07) shall be ineligible for further wage-loss compensation for temporary disability arising out of the same injury for which the schedule award has been approved or paid.

140.11 A claimant may not receive wage-loss compensation for temporary disability and a schedule award for the same injury at the same time.

140.12 Permanent disability compensation shall be limited to those body parts and functions listed in the schedule set forth in Section 2307 of the Act (D.C. Official Code § 1-623.07).

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); as amended by Final Rulemaking published at 66 DCR 4246 (April 5, 2019).