| Quick Reference Guide |
1 | Average Weekly Wage Worksheet |
2 | Calculating Lump Sum Discounts |
3A | $10,000 Lump Sum 4% Discount Whole Person (Use "PPD Lump Sum" tab) |
3B | $10,000 Lump Sum 4% Discount Scheduled Impairment (Use "PPD Lump Sum" tab) |
4 | 2024 Maximum Benefit Rates | Quick Reference Guide |
5 | Age Factor Chart |
7 | Calculating TPD Benefits |
8 | Admissions Checklist |
9 | Basic Claims Process |
10 | Evaluation of Previous Spinal ROM Impairment |
11 | Impairment Rating Tips |
12 | Mileage Reimbursement | Quick Reference Guide |
13 | Scheduled Impairment Chart |
14 | Apportionment Calculation Worksheet |
15A | Non-medical Discharge Form Letter |
15B | Non-medical Discharge Form Letter (Spanish) |