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TPD Calculations and AMA Impairment Ratings under WCA Reforms

By Christopher S. Crawford

I have fielded questions about whether the new method for calculating TPD should be applied to all claims even if the date of injury occurred before the commencement date of the Illinois Workers’ Compensation Reform Act. Given the fact that this issue is brand new, it has not been adjudicated. However, the competing handbooks posted on the web site likely provide the answer. TPD should be calculated using the old method of 2/3 of AWW-net income received if the date of injury is between 02/01/06 and 06/27/11. TPD is to be calculated using the new method of 2/3 AWW-gross pay for injuries occurring after 06/28/11.

The handbooks are not binding authority. However, their content suggests that even with the new act, TPD should be calculated using the old method for injuries occurring before the start date of the new reforms.

I have also fielded questions about how AMA guidelines will be used in the adjudication of cases given the new reforms. The Act now provides:

In determining the level of permanent partial disability, the Commission shall base its determination on the following factors: (i) the reported level of impairment pursuant to subsection (a); (ii) the occupation of the injured employee; (iii) the age of the employee at the time of the injury; (iv) the employee’s future earning capacity; and (v) evidence of disability corroborated by the treating medical records. No single enumerated factor shall be the sole determinant of disability. In determining the level of disability, the relevance and weight of any factors used in addition to the level of impairment as reported by the physician must be explained in a written order.

IL ST CH 820 § 305/8.1b.

The Act also provides that physicians shall use AMA ratings when issuing permanent partial impairment reports. The Commission recently issued guidance on these new provisions. First, the Commission stated that it is not necessary to furnish an impairment report in order to have a settlement contract approved. Second, an Arbitrator can find permanency even though an AMA impairment rating is not submitted into evidence. The conclusion is that AMA impairment ratings are not required to adjudicate a case and the ratings are but one factor in evaluating permanency.

Originally published in the Winter 2011 edition of Quinn Quarterly.