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- OR Income And Expense Statement 2015
Get OR Income And Expense Statement 2015-2024
F needed. MONTHLY INCOME (deduct taxes only) Salary: Applicant $ Spouse/Partner $ Financial Aid (actual per month): Scholarships/Grants (list by name/amount): $ $ $ Educational Loans (list by name/amount): $ $ Child Support/Alimony: $ State or Federal Government Assistance (identify source): $ $ Food Stamps: $ Monthly Income from Savings/Interest/Dividends: $ Other sources of Income (identify): $ $ #1 TOTAL MONTHLY INCOME ADDITONAL INFORMATION Total in Savings Accounts: Total in Investments: Pa.
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Applicant FAQ
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After you receive an Impairment Rating, your Temporary Income Benefits will stop and you will begin to receive Impairment Income Benefits to compensate you for your loss of function. Upon reaching Maximum Medical Improvement (MMI), an Impairment Rating needs to be given so that your benefits can continue.
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The maximum for IIBs is 70 percent of the state AWW. For example, if your Average Weekly Wage is $600, your Impairment Income benefits (IIBs) rate would be $420. If your average weekly wage were $500, your IIBs rate would be $350.
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MMI, or maximum medical improvement, means that a doctor has decided you are as well as you're going to be from your injury or illness. When the doctor says you've reached maximum medical improvement, your company's workers' comp insurer may very well try to limit your benefits or stop paying them altogether.
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The maximum for IIBs is 70 percent of the state AWW. For example, if your Average Weekly Wage is $600, your Impairment Income benefits (IIBs) rate would be $420. If your average weekly wage were $500, your IIBs rate would be $350.
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A worker with a 0 percent impairment rating is considered to have no impairment at all. Therefore, such a worker is expected to continue with their daily tasks as they would before the injury.
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If you are an injured employee who wants to appeal the decision or file a response to an appeal and you do not have an attorney, you can get free help from an ombudsman at the Office of Injured Employee Counsel (OIEC). Call OIEC at 866-393-6432 or go to the OIEC website for more information.
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Amount of impairment income benefits IIBs are 70% of your average weekly wage (AWW). This AWW is the average amount of money your employer said you get each week from your job. IIBs are paid based on the state AWW maximum and minimum amounts on a specific date. Find the state AWW amount for your date of injury.
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To calculate the impairment award, the CE multiplies the percentage points of the impairment rating of the employee's covered illness or illnesses by $2,500.00. For example, if a physician assigns an impairment rating of 40% or 40 points, the CE multiplies 40 by $2,500.00, to equal a $100,000.00 impairment award.
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To dispute your own doctor's Impairment Rating, your lawyer should talk with your doctor about increasing his impairment rating. If your doctor refuses, your lawyer can file the necessary forms and request a Benefit Review Conference. You have 90 days to dispute your own doctor or the Impairment Rating becomes final.
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The impairment rating is a percentage that represents the extent of a whole person impairment of the employee, based on the organ or body function affected by a covered illness or illnesses.
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