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What are impairment benefits?

Impairment benefits are paid at the point of maximum medical improvement, when an individual on the Heart Bill has reached a plateau. Maximum medical improvement again is a medical-legal term of art, that means your case has essentially reached a stage where there is no anticipated further recovery from a medical perspective. At that point, your doctor has to assign a whole body impairment rating and based on that impairment rating, you receive something called impairment benefits. Now with respect to heart bill claims it's very important to understand that these impairment benefits are extremely substantial. In most cases, they are tens of thousands of dollars. In rare instances, we have had cases where people are paid hundreds of thousands of dollars for whole body impairment. This is a very big and important part of the Heart Bill, and it's something that all First Responders should understand very clearly.

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If I file a work injury or Heart Bill claim, am I entitled to impairment benefits?

Yes. Almost every Heart Bill claim implicates some impairment rating. What that means is there should always be some impairment benefit paid. Again, Heart Bill claims implicate substantial impairment ratings. In the vast majority of cases, the payment of impairment benefits is in the thousands of dollars. In routine cases, payments are in tens of thousands of dollars. In the rare cases with very severe disability and impairment, the impairment benefits can exceed hundreds of thousands of dollars. To answer the question simply, almost every Heart Bill case will have an impairment benefit provision.

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How are impairment benefits paid?

Impairment benefits are paid based on the doctor's impairment rating. We then take that rating and we get the actual weeks that you would be entitled to impairment benefits. Your impairment benefits are then paid at 75% of your average weekly temporary total rate if you are not working. If you are earning what you earned for your average weekly wage, that number is reduced by 50%. It's a convoluted evaluation in calculation, that's why we like to look at it and assess those numbers.

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How do I determine if my impairment benefits have been paid correctly?

That's an interesting question. With regards to impairment benefits being paid correctly, you have to do a calculation. There's a few different things that play a role in that, what the impairment rating is by the physician, exactly how many weeks you would be due your benefits, if you were working during those weeks or not. What we do in our practice is we go back, identify what the correct impairment rating was by the physician. We calculate out the appropriate weeks, determine if you were working or not working so that we can get a correct calculation. We also have to get the information from the carrier or from the client to determine exactly what was paid.

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How do I know if my doctor has assigned a correct impairment rating?

Your doctor has to use what's called the Florida Impairment Guides in identifying what impairment rating you have. It's a convoluted process depending on what type of injury you have. Once the doctor has assessed the computation of the impairment rating, he writes it out on a DWC-25 Form. What we do in our practice is go back and check the DWC-25 or the doctor's records of an impairment rating and identify if it's correct or not. It's not an easy process. We use what's called the 1996 Impairment Guides to do so, and it's important that they get it right. They don't always get it right and it's important to check those numbers.

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If I received a check for impairment benefits, should I cash it?

There's a problem with the payment of impairment benefits on occasion, where a First Responder may receive a payment without explanation, seemingly out of the blue. Many times we receive questions from people who are asking what this payment is about. No First Responder should really negotiate these payments without a clear explanation of what it is that they're receiving. Again, this requires some level of expertise and some level of investigation, either on the part of the individual or the law firm that has been retained. It's important not to cash any of these checks for impairment benefits until you clearly understand what it is you're receiving, why you're receiving it, and whether or not cashing that check may have negative consequences down the road.

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If I received a check for impairment benefits and cashed it, is my case finished?

Many times, we receive calls from First Responders who are concerned that they have cashed a large check for impairment benefits and they have been advised that, somehow, their case is closed. Now, it's important to understand even cashing the impairment check does not mean that your case is settled. It could have potential negative consequences with regard to additional benefits, but that is not a settlement of the case. As long as you have not signed some type of overall settlement of a claim, the case will remain open, you'll still be entitled to medical care, you'll still be entitled to prescription medication, and you may be entitled to additional compensation, but it's important to get legal advice on what you need to do if you have received a large check of this kind.

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