Antioch California Request for Summary Rating for Workers' Compensation

State:
California
City:
Antioch
Control #:
CA-DEU-102-WC
Format:
PDF
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Description

This form is an official California Worker's Compensation form which complies with all applicable state codes and statutes. USLF updates all state forms as is required by state statutes and law. This form is available in fillable PDF format.

How to fill out California Request For Summary Rating For Workers' Compensation?

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FAQ

A ?rating? is a percentage that estimates how much your disability limits the kinds of work you can do or your ability to earn a living. It determines the amount of your PD benefits. Ratings are based on several factors: 1.

DWC-7 Notice to Employees-Injuries Caused by Work (English and Spanish). This form provides your employees with information regarding workers' compensation benefits and the Medical Provider Network (MPN) in California.

Definition. An overall rating based on the rating for the critical elements that describes an employee's overall performance throughout the appraisal period; this rating is considered the rating of record and is described using summary levels.

The Disability Evaluation Unit (DEU) determines permanent disability ratings by evaluating medical descriptions of physical and mental impairment.

(b) Consultative rating determinations may be requested for the purpose of determining the ratable significance of factors, reviewing proposed compromise and release agreements for adequacy, determining commuted values, resolving occupational questions or any other matters within the expertise of the disability

The Disability Evaluation Unit (DEU) determines permanent disability ratings by evaluating medical descriptions of physical and mental impairment.

In California, these benefits are calculated at two-thirds of your average weekly wages before the accident. However, there is a legal maximum and minimum that changes every year, depending on the statewide average wages. For 2022, the weekly maximum is $1,539.71, and the minimum is $230.95.

A summary rating is a document issued by the Disability Evaluation Unit that turns a doctor's report about your injury into a permanent disability rating. Summary ratings are given out after all qualified medical evaluator (QME) exams and after treating doctor exams, when requested.

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Antioch California Request for Summary Rating for Workers' Compensation