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Phil Walker

On April 19, 2004, in a Boeing hangar in Long Beach, California, Governor Arnold Schwarzenegger signed into law aggressive workers’ compensation reforms known as SB899. The reform is targeted to ultimately reduce workers’ compensation premiums for California's employers while speeding medical treatment to injured workers. The changes in California's workerscompensation law are far-reaching and include the use of the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition , to assess impairment as a component in the California assessment

in AMA Guides® Newsletter
Steven D. Feinberg

) substantial medical evidence; (2) causation; and (3) apportionment, all of which directly affect benefit delivery to injured workers. This article discusses the special aspects of addressing and defining substantial medical evidence, causation, and apportionment in the California Workers' Compensation system, and it applies these definitions to examples of cases. In addition, it also includes case scenarios that highlight how evidence-based medicine (EBM), genetics, and age differences could affect these three components (substantial medical evidence, causation, and

in AMA Guides® Newsletter
Steven Feinberg
,
Kenneth Kingdon
, and
Robert Rassp

California's workerscompensation system had been determined by medical–legal evaluations by physicians who assigned actual and prophylactic work restrictions based on subjective complaints and objective medical findings. These restrictions were applied to a “permanent disability rating schedule” (PDRS) that was adopted by regulation. 2 Each “standard disability rating” such as “no heavy work” was assigned a percentage of PD (30% for that restriction of no heavy work, which would translate into the injured worker being assigned permanent loss of 50% of preinjury physical

in AMA Guides® Newsletter
Christopher R. Brigham
,
James Talmage
,
Marjorie Eskay-Auerbach
, and
Patty Stevens

the lumbar spine. State of California Almaraz/Guzman Rating In his April 2010 report, the evaluating physician provides a rating of the lumbar spine referencing the Almaraz/Guzman II decision. He also provides a letter dated January 2011, confirming the prior rating referencing the Almaraz/Guzman II decision. The State of California Workers' Compensation Appeals Board (WCAB) issued a decision on February 3, 2009, in the consolidated cases of Almaraz vs. SCIF et al. and Guzman vs. Milpitas Unified School District (Almaraz/Guzman). On September 3, 2009, the

in AMA Guides® Newsletter
Restricted access
Christopher R. Brigham
and
Henry J. Roth

physician needs to verify the following information: That there is documentation of a prior factor That the current permanent impairment is greater as a result of the prior factor (ie, prior impairment, prior injury, or illness) That there is evidence indicating the prior factor caused or contributed to the impairment, based on a reasonable probability (>50% likelihood) California Workers' Compensation Reform: Senate Bill 899 Sweeping changes are occurring in California as a result of workers' compensation reform and enactment of Senate Bill 899 on April

in AMA Guides® Newsletter
Christopher R. Brigham
and
W. Frederick Uehlein

The State of California Workers' Compensation Appeals Board (WCAB) February 3, 2009 decision in the consolidated cases of Almaraz vs SCIF et al. and Guzman vs Milpitas Unified School District (Almaraz/Guzman) concluded that the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition ( Guides ) portion of the 2005 Permanent Disability Rating Schedule is rebuttable 1 . Such decisions of the California Appeals Board are binding precedent on all California Appeals Board panels and workers' compensation judges unless overruled by the Appellate or

in AMA Guides® Newsletter
Steven D. Feinberg
and
Christopher R. Brigham

advocates, their opinions are often more favorable to the patient; furthermore, reports issued by treating physicians are typically less costly than obtaining an IME, and plaintiff attorneys may refer to certain treating physicians. In some venues, the physician may be utilized by both sides jointly; in the California workers' compensation system, this is referred to as the agreed medical examiner. When the physician provides treatment, the doctor-patient relationship is one of trust. The physician is acting as an agent for the patient. When performing an IME, the

in AMA Guides® Newsletter
Seth A. Seabury
,
Frank Neuhauser
, and
Teryl Nuckols

body regions over others. Focusing on workers’ compensation injuries was appropriate because use of the AMA Guides is widespread and highly systematized in this setting, with many states requiring its use through statute. Here we provide a brief overview of our methods and summarize the main findings. For more detail, see the full study, which was published recently in the Journal of Occupational and Environmental Medicine . 15 Data and Methods Data Our study uses data on permanent disability claimants from the California workerscompensation system

in AMA Guides® Newsletter
Restricted access
Christopher R. Brigham
,
Charles Brooks
,
Mohammed Ranavaya
,
James B. Talmage
,
Marjorie Eskay-Auerbach
, and
Craig Uejo

perform a treadmill test using the Bruce Protocol, calculate VO2 Max and METS, and provide comparative charts and an overall opinion. What can I use in the Guides, Fifth Edition to provide a rating for the deconditioning? Most of these cases are on a lien and all are in litigation. Answer: Your question is an interesting one, reflecting challenges that appear unique to the California workers' compensation arena. Physicians have been encouraged by certain stakeholders to use approaches in rating that are not used elsewhere. Deconditioning would not be rated for

in AMA Guides® Newsletter
Christopher R. Brigham
and
Jenny Walker

straight leg raising tests or range of motion tests when making physical or anatomical impairment ratings to the spine. California Fifth Edition CA Code of Reg. Title 8, Ch. 4.5 Sub Ch. 1 Art. 7 Schedule for Rating Permanent Disability, an impairment-based rating system which is based on the Fifth Edition and modifies ratings based on adjustments for Future Earning Capacity, occupational demands and age. Fifth Edition adopted as of January 1, 2005. California Workers' Compensation Appeals Board issued a decision February 2009 in the consolidated cases of

in AMA Guides® Newsletter