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Date of birth:
Date of injury:
AMA Chapter & Table (optional):
Table Name: {{ fillable.tableName }}
Select impairment number:
Or, select injury name:
Body side:
Whole Person (WPI)(or Standard): %
Occupation by group number:
Or occupation by name:
Occupation description:

{{ fillable.occupation_description }}

Percent industrial (apportionment): %
Average weekly earnings: $
Age for calculation (DOI):
{{ result.age }}
Final formula:
{{ result.formula }}
Weeks of Indemnity:
{{ result.weeks_of_indemnity }}
Gross Indemnity:
{{ parseMoney(result.gross_indemnity) }}
Weekly Comp Rate:
{{ parseMoney(result.weekly_comp_rate) }}
Life Pension Rate:
{{ parseMoney(result.life_weekly_rate) }}