Should I Cash My Check for My Impairment Benefits?
With respect to the Heart/Lung Bill, the question of whether or not to cash an impairment check is of vital importance for first responders.
What Are Impairment Benefits?
When you reach the point of Maximum Medical Improvement or MMI, you become eligible to receive impairment benefits. As we discussed in a previous post, MMI is a medical/legal term denoting that an individual on the Heart/Lung Bill has reached a plateau. If your doctor determines you have arrived at MMI, it means they do not anticipate further recovery from a medical perspective. At that point, your doctor must assign a whole body impairment rating. Based on that impairment rating, you receive something called “impairment benefits.”
According to Florida Bar.org, “The Florida Legislature defines a permanent impairment as ‘any anatomic or functional abnormality or loss determined as a percentage of the body as a whole, existing after the date of maximum medical improvement, which results from the injury.’”
How Is A Whole Body Impairment Rating Determined?
Florida Statute 400.15 sets the criteria for the determination of the whole body impairment rating. Your treating physician must evaluate your condition after they have placed you at MMI, or six weeks prior to the expiration of your temporary wage benefits (typically 104 weeks from the date of your work accident). Per this law, your doctor is required to establish an overall MMI date and assign a permanent impairment rating, ranging anywhere from 0 percent to over 20 percent.
The percentage rating corresponds to the 1996 Florida Uniform Impairment Guides, where your physician will apply the specific medical facts of your injury to determine your appropriate impairment rating. Your doctor will state on your medical record something like, “the injured worker has sustained a 5% (or whatever they have determined your percentage rating to be) whole person impairment rating.”
In addition, Florida Statute 440.15(3) also makes it clear that the impairment rating should be made by a licensed medical, osteopathic, chiropractic, or podiatric doctor, based upon the Florida Uniform Permanent Impairment Rating Guidelines. In assessing the severity of your injury, the rating guidelines employ numerous criteria, allowing for the assessment of an impairment rating for conditions including:
- Coronary Artery Disease (CAD)
- Heart Attacks
And the many other injuries and restrictions you may have sustained on the job. Since the guidelines exceed 100 pages, it can be difficult to calculate a Florida Impairment Rating.
The Purpose of an Impairment Rating
An impairment rating entitles you, the injured first responder, to additional monetary benefit under the statute. Florida Statute 400.15 defines the ways in which impairment benefits are calculated:
- For each percentage point of impairment from one-percent, up to and including 10-percent, the injured employee must be paid two weeks of benefits.
- For each percentage point of impairment from 11-percent, up to an including, 15-percent, the injured employee must be paid three weeks of benefits.
- For each percentage point of impairment from 16-percent, up to and including 20-percent, the injured employee must be paid four weeks of benefits.
- For each percentage point of impairment from 21-percent and higher, the injured employee must receive six weeks of benefits.
The benefit, or amount of money to which you are entitled, is calculated at 75% of your WEEKLY compensation rate. With respect to Heart/Lung Bill claims, impairment benefit totals COULD BE substantial. Because impairment benefits comprise a major portion of the Heart/Lung Bill, it’s in the best interest of all first responders to understand them clearly.
Should I Cash My Check for My Impairment Benefits?
We often receive calls from first responders who are concerned that they have cashed a large check for impairment benefits, and have been advised that somehow their case is closed. Let us assure you, cashing your impairment benefit check does not mean your case is settled...although it could have potentially negative consequences with regard to additional benefits. As long as you have not signed some type of overall settlement documents for the claim, your case will remain open, provided that you continue to treat with your authorized physician at least once every 364 days to prevent the statute of limitations from running. You’ll still be entitled to medical care at the expense of workers’ compensation if you remain on your yearly treatment schedule. You’ll still be entitled to prescription medication. However, if you receive a large check for impairment benefits, we highly recommend that you obtain legal advice on what to do before you cash it.
Have you been assigned an impairment rating and have questions about impairment benefits under the Heart/Lung Bill?
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Disclaimer: The information in this blog post (“post”) is provided for general informational purposes only, and may not reflect the current law in your jurisdiction. No information contained in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.
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