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What is a Part E Impairment Rating?
February 2, 2018
February 2, 2018
If your claim is approved under Part E you receive medical benefits first, then request an impairment rating to determine if you are eligible for a monetary settlement as well. The Final Adjudication Branch (FAB), concludes that a person contracted a covered illness due to exposure to a toxic substance at a covered Department of Energy facility or Radiation Exposure Compensation Act Section 5 facility and sends you a Final Decision Letter.
An impairment award is monetary compensation for the permanent loss of function of a body part or organ, due to a covered illness, as established by medical evidence and measured by percentage points. For each one percent of impairment, $2,500 is awarded. A specially trained physician will perform your rating. They use the AMA’s Guides to the Evaluation of Permanent Impairment, Fifth Edition, and determine the amount of settlement you may be eligible to receive. However, if you previously received any monies from State Worker’s Compensation or Third Party Suits this may affect your benefits. You may wish to discuss this with your attorney or authorized representative, prior to requesting an impairment rating, to ensure no loss of medical benefits will be incurred.
The impairment process can be repeated every two years since the last Final Decision letter was received for the impairment rating (date of the final decision letter). You would also want to be sure your condition was worse than it was at the previous rating, prior to requesting another rating or you could possibly receive a 0% increase and have to wait another 2 years from this decision to repeat the process. Any time after the two year criteria is met, should your condition worsen, you would request another rating at that time. Your approved condition(s) does have to be at MMI (maximum medical improvement) and which means the condition is well-stabilized and unlikely to improve with medical treatment. There are exceptions to the two year rule; you receive approval for another new condition prior to the 2 year time frame, or you become terminal within 6 months from an approved condition. A terminal condition does not have to be at MMI to have a rating performed.
You have two choices regarding the physician who does you rating. One way is for you to request that the DOL choose a physician for you. This means the DOL will send your medical records and Activity of Living form (completed by your treating physician) to an independent physician for their review and determination of your percentage. The second way is for you to choose your own physician and submit his name and contact information. This does not necessarily mean your own personal physician, as they may not hold the qualifications to perform a whole body impairment.