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PERMANENT DISABILITY RATING, 1997 SCHEDULE: FOREARM IMMOBILITY

Date of birth:  
Date of injury:  4/1/1997 to 12/31/2004.
Forearm pronation:injured: °   uninjured: °
Forearm supination:injured: °   uninjured: °
Loss of radial head?
Major forearm?
Fraction:
Standard Rating:%
Occupation by group number:
Or occupation by name:
Occupation description:
Percent industrial (apportionment):%
Average weekly earnings:$
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Age for calculation (DOI):
Final formula: 
Weekly Comp Rate:
$
Life Pension Weekly Rate:
$
Indemnity:
$
Weeks of Indemnity:
TTD Applies Rate: 

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