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PERMANENT DISABILITY RATING, 1997 SCHEDULE: PSYCHIATRIC

Date of birth:
Date of injury:	4/1/1997 to 12/31/2004.

Group I
Ability to comprehend and follow instructions.
Ability to perform simple and repetitive tasks.
Ability to maintain a work pace appropriate to a given work load.
Group II
Ability to perfom complex and varied tasks.
Ability to relate to other people beyond giving and receiving.
Ability to influence people.
Inability to make generalizations, evaluations or decisions without immediate supervision.
Ability to accept and carry out responsibility for direction, control and planning.

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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