California primary treating physicians use PR-3 to report the initial evaluation of permanent disability to the claims administrator when the rating falls under the 1997 Permanent Disability Rating Schedule, which applies to older injuries. It is completed once a patient with residual effects or future care needs is permanent and stationary, covering subjective and objective factors, restrictions, future treatment and apportionment.
Only the primary treating physician completes it; a QME or AME must not use PR-3 to report a medical-legal evaluation.
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Primary Treating Physician's Permanent and Stationary Report (PR-3)
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PR-3 is for ratings prepared under the 1997 Permanent Disability Rating Schedule, which covers older injuries. Ratings under the 2005 schedule and the AMA Guides 5th edition require PR-4. Both are completed by the primary treating physician once the patient is permanent and stationary.
The form defines pain severity as minimal, slight, moderate or severe, and frequency as occasional, intermittent, frequent or constant, and asks for the precipitating activity. It also asks for pre-injury and current capacity, such as how much the patient could lift before the injury and can lift now.
No. The form states it should not be used by a Qualified Medical Evaluator or Agreed Medical Evaluator to report a medical-legal evaluation. It is the primary treating physician's report of the initial evaluation of permanent disability to the claims administrator.