Here is an impairment rating template compatible with the state’s rule set

Impairment Rating Template for State Specific Rule Set (Word file)

Administrative Rule Set

Here is a link to the State Guidelines for Determining Permanent Impairment and Loss of Wage Earning Capacity

Physician’s Report

Doctor’s Progress Report

Here is a link to the Doctor’s Progress Report

Doctor’s Report of MMI/Permanent Impairment

Here is a link to the Report of MMI/Permanent Impairment

Labor Department

Here is a link to Department of Labor