Who pays for an impairment rating?
A – Generally, DOL pays for one impairment evaluation as long as the evaluation meets the criteria outlined in the regulations. The evaluation must have occurred within one year of the date of its receipt by DOL. In addition, the physician must meet sufficient criteria to establish expertise in the use of the AMA’s Guides. The cost of obtaining additional evaluations may be covered at the claims examiner’s discretion. Ratings performed by physicians who do not meet DOL’s qualification standards for performing evaluations are not reimbursable. Q28 – When does an individual with a chronic disease such as asbestosis reach “maximum medical improvement?” A – DOL regulations allow for determining an impairment rating when an illness is “well-stabilized and unlikely to change substantially with or without medical treatment.” DOL expects to award impairment ratings for chronic disease under this formulation without the need for those claimants to wait for a recovery that is unlikely to occur.
