ÿWPC— Ûým÷­ÄO9TÈ:êh¶éÁè¬g_Oܲðü“µôËO7Šð³"ШpÜ^J£þaí0ú3¢U3À<GqVSý“×-µÚ…Ìíj $çxH6ØK²¨ï“O çgñ­ @,0‹L8AµJncØ,t°Ï¤?¡Ñ­[È‹ù-,ë:[0‘ªodçjiH>t³MË n8‰…UeºF¬¦õ,îq„zs1 r”¹²’—F_)>b¢?åWè%z/A']àÚÎgŸu°{ É‚hB^ä&)NéEA“¾*(žÌÖNMZ›@ÏN(qv¼Wa«^΂ۆôÔdÁCÔ‚D•WÁÂáÍ´gQ¶ã¸Óœm\³rp$Ôß ±Ã)¼®ù0ª|6.¢k*Œ ‰î̼ëgC¨ð'3~Ž‹~ «C‹:>?J…ÞšuŸÀNh; ´&fwïžrýñÉ6ÄjżeêÒ% #ɶUN %Í 0(Ówû4ÿN"N$^ r~ m€˜\\FLSRVR\SHARP AR-651 PCL SHüüüüüüüü0(ÖÃ9 Z ‹6Times New Roman RegularX($¡¡dŽñ.úÿÿú, ú3|x  WCAB TTD RRTW DOIcontd¤v²0Ï ÿU‹ÿÀÀÀÝ ƒ!ÝÝ  ÝÔ_Ôò òTemporary€Disabilityó óÐ ° ÐÌÓ€Ó1.à  à____________€compensation€to€help€replace€lost€incomeÐ l¼ Ðà  àA.€Types:Ð ¹  Ðà  àà ` à1.à ¸ à_________________________________Ð  V Ðà  àà ` à2.à ¸ à_________________________________Ð S £ Ð2.à  àTemporary€disability€is€paid€when€worker€cannot€perform€______€work€as€a€result€of€Ð   ð  Ðà  àindustrial€injuryÐ í =  Ðà  àA.€_____€time€limit€if€accepted€claim€paid€by€insurerÐ :Š  Ðà  àB.€___________€when€worker€returns€to€work€or€when€doctor€certifies€worker€can€return€Ð ‡×  Ðà  àto€work€or€when€doctor€determines€worker€is€Permanent€and€StationaryÐ Ô$  Ð3.à  àTreating€doctor€usually€makes€determination€of€_____€statusÐ !q  Ðà  àA.€If€there€is€a€dispute€about€workerððs€status,€then€a€_____€may€be€selected€to€determine€Ð n¾ Ðà  àthe€issue€or€an€_____€if€worker€is€represented€by€an€attorneyÐ »  Ð4.à  à________€party€may€request€a€hearing€(expedited)€before€the€WCAB€to€determine€TTD€Ð X Ðà  àstatusÐ U¥ Ð5.à  à__________________________€is€payable€when:Ð ¢ò Ðà  àA.€Doctor€indicates€RRTW€limited€______€or€_____Ð ï?  Ðà  àB.€Worker€returns€to€work€______________€pursuant€to€doctorððs€orders€or€because€Ð <Œ" Ðà  àemployer€does€not€have€limited€duty€available€full„timeÐ ‰Ù$ Ðà  àC.€Limited€to€_____€weeks€within€a€period€of€_____€yearsÐ Ö&& Ð6.à  àTD€Calculation:€_____________________________€with€set€minimums€and€maximums€Ð #s( Ðà  àpursuant€to€the€DOIÐ p À* Ðà  àA.€TD€rate€is€locked€in€for€____€years€from€DOIÐ ½! , Ðà  àB.€After€_____€years,€rate€may€be€increased€to€the€current€rate€if€AWE€justify€theÐ  #Z. ÐincreaseÐ W$§0 Ð7.à  àAWE€are€determined€on:Ð ¤%ô 2 Ðà  àA.€_______________________€before€taxes€are€deductedÐ ñ&A"4 Ðà  àB.€Income€from€all€______________€jobsÐ >(Ž#6 Ðà  àC.€______________€is€not€includedÐ ‹)Û$8 Ðà  àD.€Market€value€of€__________________,€tooÐ Ø*(&: ÐÌÐ r-Â(> Ðò òTemporary€Disability€(contððd)ó óÐ ° ÐÌ8.à  àAWE€does€not€include:Ð Jš Ðà  àA.€______________Ð —ç Ðà  àB.€______________Ð ä 4 Ðà  àC.€______________Ð 1   Ð9.à  àEvidence€to€support€AWE€might€be:Ð ~ Î  Ðà  àA.€______________Ð Ë   Ðà  àB.€______________Ð h  Ðà  àC.€______________Ð eµ  Ðà  àD.€______________Ð ²  Ð10.à  à_________________€considered€for€AWE€may€be€„Ð ÿO Ðà  àA.€Generally€____________€of€employmentÐ Lœ Ðà  àB.€_____________________€might€be€included€if€within€the€one€year€periodÐ ™é Ðà  àC.€____________________€worked€if€less€than€one€yearÐ æ6 Ð11.à  àCalculation€of€AWE:Ð 3ƒ Ðà  àA.€______________€grand€total€by€actual€weeks€of€payÐ €Ð  Ð12.à  àWorker€might€qualify€for€higher€TD€rate€if€just€received€a€_______________€or€à Ð àÐ Í" Ðà  à_______________Ð j$ Ð13.à  àTemporary€Disability€is€paid€every€_____€weeksÐ g·& Ð14.à  àInjured€worker€might€file€for€_____€if€insurance€company€delays€or€denies€claimÐ ´( Ð15.à  àIf€TD€paid€late,€worker€is€entitled€to€automatic€additional€payment€of€_____€for€penaltyÐ  Q* Ðà  àA.€No€TD€is€paid€within€first€_____€days€after€DOI€unless€disability€lasts€more€than€14€Ð N!ž, Ðà  àdays€or€requires€______________Ð ›"ë. Ð16.à  àNo€TD€due€if€worker€received€____________€or€________________€or€____________€Ð è#80 Ðà  àwhile€off€work