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COMMUTATION OF PERMANENT DISABILITY

Date of injury:

PD commencement date:

Date of commutation (DOC):

Permanent Disability (PD) Rating:

PD Rating values of 100% requires use
of Commutation PTD - Life Pension

PD Weekly rate:

$	Weekly Wage: $

If PD Was Paid in Broken Periods Enter Total Amount of Payments Prior to DOC:

$ Required for "far end."

Amount to be commuted:

$ For "far end" and "uniform reduction."

Commutation of all remaining PD:
Number of days from commencement through DOC:
Number of weeks from commencement through DOC:
Total number of weeks of indemnity at % PD:
Weeks of PD remaining after DOC:
Present value (PV) of weeks of PD remaining after DOC:
Commuted Value of PD Remaining:	$
Commutation of PD “off the far end” to produce a specific lump sum:
Present value (PV) of amount to be commuted:
PV of weeks remaining after commutation off far end:
Weeks of PD remaining after commutation off far end:
PD still owed for period after DOC:	$
Number of weeks of PD eliminated from the far end:
Amount of future benefits commuted:	$
Interest owed carrier (or savings to carrier):	$
Amount to pay claimant to bring commutation to even weeks:	$
Weeks of PD remaining after payment to bring weeks even:
Compute secondary / supplemental commutation:	Click here to subscribe!
Commutation of PD by uniform reduction of payments:
Amount of reduction required to produce lump sum:	$
New PD rate after reduction:	$
Amount of PD still owed for period after DOC:	$
Compute secondary / supplemental commutation:	Click here to subscribe!

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