GQ Corner

Q. Claimant has reached statutory MMI.  I have made a reasonable assessment of 1%. Am I also required to obtain an actual certification of MMI and IR?  We have not received a certification to date, although one has been requested from the treating doctor.

A. There is no requirement to obtain a rating. Rule 130.2(e) outlines your options, but note that these are discretionary and not mandatory. 

Specifically, subsection (e) provides that if Carrier has not received an MMI/IR certification from an evaluating doctor by the date of statutory MMI:

1. 1. 1. Carrier may suspend TIBs and is not required to initiate impairment income benefits (IIBs) until such time as it receives an MMI/IR report from an evaluating doctor;
      2. Carrier may request the appointment of a designated doctor; and/or
      3. Carrier may make a reasonable assessment of what it believes the true impairment rating should be and, if it does so, shall initiate IIBs within five days of making the assessment. The carrier shall continue to pay IIBs until the assessment is paid in full or is superceded by an impairment rating assigned by an evaluating doctor.