Hamberger & Weiss LLP


Board Continues “New” SLU Guidelines Rollout with New Forms, Training

The Board continues its implementation of its 2018 Impairment Guidelines with Subject No. 046-1067, in which the Board provides new forms that both attending physicians and Independent Medical Examiners are required to use effective immediately in providing opinions on schedule loss of use (SLU). We believe that the required forms continue the Board’s tradition of legislating through forms, but with respect to the SLU issue are generally favorable to the employer and carrier community because they force examiners to perform some actions suggested in the 2018 Guidelines, such as measuring the contralateral extremity.

The employer and carrier community should take careful note of the Board’s new requirements for IME forms. According to Subject No. 046-1067, an IME evaluator must fill out not only the IME form cover sheet, but provide the appropriate listed attachments for either an SLU evaluation or a non-schedule PPD evaluation along with the evaluator’s narrative report. All three elements (IME-4, permanency attachment, and narrative) are required for a complete IME report. The IME-4 attachments (“A” for SLU evaluation, “B” for classification evaluation) essentially mirror their attending physician counterparts, discussed below.

The IME-4 form also has been changed to require the evaluator to indicate the start time of the patient’s examination, the end time of the examination, and the total time spent by the evaluator reviewing records. The IME evaluator should take care to make sure that all sections of the IME form and any appropriate attachments are filled out when completing an IME report. An IME-4 cover sheet with narrative is no longer sufficient.

The new C-4.3 form now has two required attachments. The first, Attachment A, is to be completed by an attending physician conducting an SLU evaluation. Of note, the attachment indicates that the examining physician should provide three measurements for range of motion, compare range of motion to the contralateral extremity, and requires specific notation of the applicable special consideration, if any.

Attachment B of the new C-4.3 form is relevant to non-schedule classifiable cases and is largely unchanged from Section F of the old C–4.3 form. The new attachment does, however, contain additional space for describing the claimant’s work status, and more detail in consideration of the claimant’s functional capabilities and exertional abilities.

Earlier this month, the Board offered training on the new SLU guidelines and the new forms required. Although the webinar series is over, a recording is available and parties can review the Board’s PowerPoint presentation on the Board’s website here.

Back to News

Copyright © 2023 Hamberger & Weiss LLP