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<chapter num="09" heading="Guide for Evaluation of Permanent Disability" title_num="14" subtitle_num="09">
  <regulation prefix="Regulation" num=".01" heading="Incorporation by Reference.">
    <text>Guides to the Evaluation of Permanent Impairment (American Medical Association, Fourth Edition, 1993) is incorporated by reference.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Filing Issues.">
    <paragraph num="A.">
      <text>A claimant alleging permanent disability shall file with the Commission an issues form that:</text>
      <paragraph num="(1)">
        <text>Explicitly claims permanent partial or permanent total disability;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Identifies the body parts at issue; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Identifies any alleged psychiatric disability.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Prior to filing an issues form raising permanent disability, the party filing the issue shall have obtained a written evaluation of permanent impairment prepared by a physician, psychologist, or psychiatrist in accordance with Regulation .03 of this chapter.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Evaluation of Permanent Impairment.">
    <paragraph num="A.">
      <text>Written Evaluation Required. As evidence of permanent impairment, a party shall submit:</text>
      <paragraph num="(1)">
        <text>A written evaluation of permanent impairment prepared by a physician; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>In claims where the issue concerns psychiatric impairment, a written evaluation of permanent psychiatric impairment prepared by a licensed psychologist or psychiatrist.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>When preparing an evaluation of permanent impairment, a physician, psychologist or psychiatrist shall:</text>
      <paragraph num="(1)">
        <text>Generally conform the evaluation with the format set forth in §2.2 (“Reports”) of the American Medical Association's “Guides to the Evaluation of Permanent Impairment”;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Use the numerical ratings for the impairment set forth in the American Medical Association's “Guides to the Evaluation of Permanent Impairment”, provided that a physician, psychologist or psychiatrist is not required to use the inclinometer evaluation technique specified in §3.3, but instead may use the goniometer technique specified in the “Addendum to Chapter 3”;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Include the items listed under the heading “Comparison of the results of analysis with the impairment criteria . . .” in §2.2 (“Reports”) of the American Medical Association's “Guides to the Evaluation of Permanent Impairment”; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Include information on the items required by Labor and Employment Article, §9-721, Annotated Code of Maryland:</text>
        <paragraph num="(a)">
          <text>Loss of function, endurance, and range of motion; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Pain, weakness, and atrophy.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Numerical Ratings.</text>
      <paragraph num="(1)">
        <text>A physician, psychologist or psychiatrist preparing an evaluation of permanent impairment may include numerical ratings not set forth in the American Medical Association's “Guides to the Evaluation of Permanent Impairment” for the items listed in §B(4) of this regulation.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If the physician, psychologist or psychiatrist uses other numerical ratings the physician shall include in the evaluation the detailed findings that support those numerical ratings.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>When reviewing an evaluation for permanent impairment, the Commission shall consider all the items listed in §B of this regulation.</text>
    </paragraph>
    <paragraph num="E.">
      <text>The Commission may not approve payment of a physician's, psychologist's or psychiatrist's fee for an evaluation that does not comply with this regulation.</text>
    </paragraph>
    <paragraph num="F.">
      <text>This regulation shall apply to all evaluations prepared on or after July 1, 1990.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Stipulation for Permanent Disability.">
    <paragraph num="A.">
      <text>A written stipulation to an award for permanent disability shall be filed using the stipulation of parties and award of compensation form and contain the following information:</text>
      <paragraph num="(1)">
        <text>The claimant's average weekly wage;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The inclusive dates of any temporary total disability;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The inclusive dates and rate of any temporary partial disability;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>A copy of any medical evaluation relied upon;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>The percentage of claimant's loss of use or industrial loss of use and the benefits weeks payable;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Any medical expenses claimed;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Any attorney's fees sought by claimant's attorney; and</text>
      </paragraph>
      <paragraph num="(8)">
        <text>The signatures of all parties if a written stipulation is submitted.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>If the claimant is not represented by an attorney, the stipulation shall be accompanied by the following:</text>
      <paragraph num="(1)">
        <text>All medical information in the possession of other parties; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A statement signed by the claimant acknowledging that the claimant understands that the stipulation does not foreclose the claimant's future right to benefits under the Workers' Compensation Law, including the right to reopen and the right to continuing medical treatment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The stipulation is not binding on the Commission unless approved by the Commission.</text>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Labor and Employment Article, §§9-309, 9-701, 9-721, and 9-731, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: March 15, 2004 (31:5 Md. R. 451)</annotation>
    <annotation type="History" subtype="Administrative History">Regulations .01—.16, Public Information Act Requests, recodified from COMAR 14.09.09 to COMAR 14.09.16, Public Information Act Requests, effective March 3, 2014 (41:4 Md. R. 305)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter revised, Regulations .01 and.03 recodified from 14.09.04, Guide for Evaluation of a Permanent Impairment, to COMAR 14.09.09, Guide for Evaluation of a Permanent Disability, effective March 3, 2014 (41:4 Md. R. 305)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02 adopted effective March 3, 2014 (41:4 Md. R. 305)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02 amended effective October 18, 2021 (48:21 Md. R. 890)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 adopted effective March 3, 2014 (41:4 Md. R. 305)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04A, C amended effective October 18, 2021 (48:21 Md. R. 890)</annotation>
  </annotations>
</chapter>