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http://www.pdratings.com/ |
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Certified, Impairment
& California Workers Compensation Disability Rating Specialists American College of
Disability Medicine & American Board of Independent Medical Examiners |
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Luis
Pérez-Cordero / pdrating@pacbell.net
Craig A. Lange
/craigalange@pacbell.net |
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Voice: (415) 861-4040 / Main Fax: (415) 276-3741 Central Valley Fax: (916) 848-3582 / Southern
California Fax: (619) 374-7334 |
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PD Rating Request Form ¯ (X) Check Required Service |
Check for Rush
Service: |
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¡ 1 Business Day $45 |
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¡ Same Business Day $60 |
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¡ 2
Business Days $35 |
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¡CAL Basic Rating: Mathematical Corrections Only. Disability Formulas based
on Reported
Impairment. Adjustments under either the 05PDRS or 97PDRS (1st MD/Med Rpt.). $75-95 When report does not comply with the AMA Guides, we will provide a
Comprehensive Rating. |
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¡CAL Comprehensive Rating: Disability Formulas & Verifies
report WPI calculations comply with AMA Guides & California rating
criteria. Corrects misapplications of AMA Guides Rating Criteria and
miscalculations of WPI. Combines multiple disabilities as per 05PDRS
Guidelines. $95-175 |
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¡CAL Reports or DEU/Private Rating Analysis: Addresses deficiencies
& inconsistencies to established procedures: AMA Guides, 97PDRS/05PDRS,
California & WCAB Guidelines. Findings
are checked with the Guides criteria to determine the proper calculation of
impairment and disability (Comparative
& Recommended Formulas included). $125-195 |
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Check
(X): |
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¡(CAL) PTP/Consult |
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¡(CAL) QME |
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¡(CAL) AME/OTHER |
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¯ AMA Impairment Analysis (Other States) ¯ |
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Check
(X): State/Guides |
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¡
Nevada 5th
Edition |
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Utah 5th Edition |
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Texas 4th Edition |
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Colorado (2008) |
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Hawaii (2008) |
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¡AMA
Impairment Analysis: Reported
findings are checked with the appropriate Guides’ Edition rating criteria to
determine if proper calculation of impairment has been made. Includes
corrections of WPI miscalculations & addresses misapplications of AMA
Guides Rating Criteria. Also includes annotated corrections and
easy-to-follow formulation tables that indicate proper medical findings for
the given Impairments. $95-195 |
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Check
(X): Return Via |
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¡
E-Mail |
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Fax |
California |
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¡97PDRS |
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¡05PDRS |
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E-Mail Address |
Fax Phone # |
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Name Of Requestor Ú |
Direct Voice Phone # w/Ext |
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Carrier/Adjusting
Agency/Employer |
Claim/File
# / DWC/WCAB File # / DEU # |
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Employee Name |
SS # |
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Employer |
Occupation |
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Date
of Injury / CT Date |
Date
of Birth / Age On DOI |
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Injury To (Joint / Organ
/ Body Region or System) |
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Remarks/Other: |
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To mail a complete
file/multiple reports: email craigalange@pacbell.net for mailing address. |
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Online Service Request
Form: http://www.pdratings.com/ratingrequest.html ©LPC/CAL (09-10-07) |
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