New Attachment for Schedule Loss of Use Stipulations

There are two types of permanency evaluations:

  1. Schedule awards for the impairment of extremities, vision loss, hearing loss, or facial disfigurement
  2. Non-schedule classification as a permanent partial or total disability.

On October 4, 2019, in subject number 046-1211, the Board issued specific circumstances where a new attachment must be used when stipulating to schedule loss of use and non-schedule sites are also involved.

The new stipulation must be used in three situations:

  1. When there is no medical report from either party regarding the established non-schedule injuries
  2. When both parties have medical reports that opine permanency to established non-schedule injuries
  3. When there is conflicting medical evidence from either party regarding whether there is permanency to established non-schedule injuries.

When either of the above situations are present, the Board requires the following sentence to be contained in the stipulation: “The Stipulation Attachment is incorporated by reference into the terms of [this Stipulation-or-these Proposed Findings] as if fully set forth herein.”

The questionnaire contains 10 questions to ensure that a claimant is aware of the implications of stipulating to schedule loss of use when there are non-schedule injuries involved. The fourth question confirms if there is no permanency to non-schedule injuries, (a) the claimant is not currently actively treating for the condition(s) and (b) the claimant’s medical provider has not indicated that active treatment or surgery is anticipated.

The fifth question addresses the specific situation where the claimant’s medical provider has opined permanency to a non-schedule site. If the treating physician opined permanency to a non-schedule site, the questionnaire asks whether: (a) the medical provider opines a permanent impairment does not affect the claimant’s ability to work; (b) there has been no surgery, or post-surgical care, for at least the past 12 months; and (c) the claimant has not actively treated for the condition(s) for at least six months.

Although insurance carriers and employers do not need to sign the stipulation, it is vital to be aware of these changes in order to avoid undue delay and additional expenses.

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