Talk to your doctor about how you can save 15% or more on your reptile dysfunction medication

A friend of mine is an Applicant’s attorney who uses dictation software with his work computer. [1] As you may know, dictation and voice recognition software is pretty good – but it is not always successful.  My friend, I’ll call him “Tom,”[2] was sending an e-mail demand for medication to a defense attorney using his dictation software.  The software got the phrase wrong, but given that the result was extremely entertaining, he sent it anyway.

What was his demand, you may ask?

Medication for his client’s “reptile dysfunction.” [3]

1. Photo courtesy of dmuphotography
2. After all, that is his name…
3. Other possible names for this post:
   • I got 99 problems, and a reptile ain’t one
   • Reptile problems
   • What do Bob Dole and the Geiko gekko have in common?

Look up! Dates!

A few weeks ago I e-mailed an Applicant attorney friend of mine[1] and got back a one word response.  I jokingly chided him for being so chatty.  His response was thus:

No new blog = minimal response

Well, for Z and everyone else out there, here’s a new blog post![2]  Over the weekend I updated several aspects of the website. [3]  Here’s a short summary:

1. Updated MPN / Medical Provider Lists.  I’ve added a lot more MPN names, links, and passwords.  If you have some new ones, please send them over.  I’ve also improved the link structure to help prevent broken links.
2. Updated workers’ compensation calculators.  I’ve added a few small features that should make the calculators work a little better.
3. Improved site speed.  I’ve added a little extra website-internet-magic-mojo that should improve the entire site’s performance.
4. Something new!  I’m working on a brand new calculator.  If you like playing with calculators, kicking-tires, and dishing out criticism, drop me a line and ask to be a beta tester.
5. Finally, if you see any weirdness over the next few days, please drop me a line and let me know so I can take care of it!

But, enough about me!  How are you?

1. I’ll call him “Z.”
2. There are two kinds of blog posts I really hate to read.  Blog posts that apologize for infrequent posting and blog posts that talk about the frequency of blog posts.
3. Photo courtesy of Agent Smith

It's been a wild ride

Just over a month after oral argument the Court of Appeal has issued their ruling, reversing the en banc decisions of the Workers’ Compensation Appeals Board, annulled the award of permanent disability to Ms. Ogilvie, and remanding the case for further proceedings. [1]

So, what does this new Ogilvie decision mean for us?

1. The calculations from the en banc decisions of Ogilvie I/II are no longer valid.
2. An injured worker can still rebut a scheduled rating in accordance with Costa v. Hardy and L.C. 4660 .
3. An injured worker may rebut a scheduled rating in one of three ways:
   1. Demonstrating “a factual error in the application of a formula or the preparation of the schedule.”  (Ogilvie III, p10-11).  Given the examples provided, probably references proving a defect in the RAND Study 2003 itself.
   2. Demonstrating impairments via LeBoeuf v. W.C.A.B. -style analysis that “the employee will have a greater loss of future earnings than reflected in a rating because, due to the industrial injury, the employee is not amenable to rehabilitation.”  (Ogilvie III, p12).  However, the increased disability must not be “due to nonindustrial factors such as general economic conditions, illiteracy, proficiency to speak English, or an employee’s lack of education.”
   3. Demonstrating “the claimant’s disability has been aggravated by complications not considered within the sampling used to compute the adjustment factor.”  (Ogilvie III, p13).  This appears to be a two-step process of having to prove a complex injury and then proving that the sample for the adjustment factor didn’t account for such injuries or complications.

Download Ogilvie v. City and County of San Francisco, Court of Appeal, A126344, A126427 aka Ogilvie III right now!

1. Photo courtesy of mpieracci

Boot Camp

The Workers’ Compensation Specialization Boot Camp on July 16 and 17 in Los Angeles was a packed house. [1]  If you missed out, there’s another chance to attend on July 30 and 31 in Concord.

If you did attend the seminar in Los Angeles, I promised you a copy of all of the cases cited during the presentation on Permanent Disability.  Here’s the basic outline along with a download link for every case I cited:

1. Permanent Disability
   1. Cal. Labor Code. Section 4660
   2. LeBoeuf v. Workers’ Comp. Appeals Bd.
   3. Costa v. Hardy
   4. Almaraz/Guzman “II”
   5. Guzman “III”
   6. Ogilvie “II”
   7. (Updated 7/29/2011!) Ogilvie v. City and County of San Francisco, Court of Appeal, A126344, A126427
      1. Read a summary of Ogilvie III here!
   8. Argonaut Ins. v. Ind. Acc. Comm (Montana)
2. Psychiatric Injuries
   1. Cal. Labor Code Section 3208.3
   2. Dept. of Corrections v. Workers’ Comp. Appeals Bd. (Garcia)
3. Apportionment
   1. Cal. Labor Code Section 4662
   2. Cal. Labor Code Section 4663
   3. Cal. Labor Code Section 4664
   4. Cal. Labor Code Section 3213 – 3213.2
   5. Escobedo v. Marshall’s
   6. Benson v. Workers’ Comp. Appeals Bd.
   7. Brodie / Welcher
4. Rating
   1. Blackledge v. Bank of America
   2. Policy & Procedures Manual of the WCAB
5. (Updated 7/18/2011!) Flash Card Take Away
   1. Please register for a free account with PDRater.com to download this file.
   2. Seriously – free as in free.  There’s no charge, no credit card anything.

1. Photo courtesy of jumpinjimmyjava

Math: The best kind of witness

Yesterday the U.S. Supreme Court heard oral argument on a 10 year old sexual discrimination law suit brought against Wal-Mart.[1]  I was listening to a summary of the oral argument yesterday when I heard this:

Scalia added that if statistical models can replace witnesses and evidence, “we must have a pretty bad judicial system.”

I was driving at the time just about lost it.  Replacing witnesses and evidence with statistical models?  Oh, Judge Scalia, you’ve clearly never practiced in Workers’ Compensation…

1. Photo courtesy of colodio

Now THAT's an old schedule case!

I heard the best workers’ compensation joke yesterday. [1]  Here goes:

• “Is this an old or new schedule case?”
• “Of course it’s old schedule.  Just look how old it is!”

1. Photo courtesy of dklimke

What has two thumbs and loves to hear itself talk? THIS GUY!!!

There was a great turn out this morning to the “How to Obtain an Accurate PD Rating with the AMA Guides” put on by the Workers’ Compensation Section of the State Bar.  We covered a lot of ground in just two hours, from the DEU perspective presented by Annalisa Faina and Barry Knight entitled “Anatomy of Rating”, to Mark Gearheart’s “Substantial Medical Evidence to Support a Permanent Disability Rating,” and my own presentation on “Litigating Ogilvie.”  There was a lively discussion on the state of Almaraz/Guzman, Blackledge, and Ogilvie. [1][2]

Thanks to everyone who e-mailed me asking for the cases cited during our presentations.  I’ll be uploading them shortly.

Tonight is the “2010 Steve Jimenez Special Recognition Awards” honoring:

• Lifetime Achievement: The Honorable Pamela Foust (Ret.)
• Judge of the Year: The Honorable Jorja FrankHon. Jorja Frank
• Applicant Attorney of the Year: Marc Marcus
• Defense Attorney of the Year: Michael Marks

If you’re attending tonight, please stop me and say hello!  (I’ve got a name tag and everything)

1. Lively as in “barely civil”
2. I’m kidding!

Three doctors is probably just plain excessive. And more than a little creepy.

My prior record for doctor depositions was three in one month.  This was not at all intentional.  It was probably a number of factors.  I tend to take more doctor depositions than most.[1] Almaraz/Guzman issues are usually best addressed during a deposition.  And, lastly it just happened to be an extra busy month.

This week I attended three doctor depositions (two set by myself, one set by a co-defendant).  I’d say that pretty well trumps three in a month.  :)

A special shout-out goes to Doctors Z, J, and C.  Thanks for putting up with me guys.  Also, special thanks to Mr. W, my co-Defendant without whom this wouldn’t have been possible.

1. Photo courtesy of Little Miss no Name.  Photo editing – all me!

The end for Milpitas USD?

Update: Download Milpitas United School District v. WCAB and Guzman, 6th Appellate District Court H034853, ADJ3341185, SJO0254688!

Looks like Milpitas Unified School District v. WCAB and Guzman is here to stay. [1] The 6th Appellate Court has just affirmed the WCAB’s decision in full.

Where does this leave us?  Well, under “Almaraz/Guzman II” we need to get a “strict AMA” and either side can obtain an “Almaraz/Guzman II” opinion from the doctors based upon rebuttal evidence, with the Judge being the final arbiter.

What else does this mean?  I’m probably going to break my personal record for the most doctor depositions in a single month.

Click here for more in depth coverage of Guzman!

1. Photo courtesy of funkandjazz

1. Ogilvie Formula
   1. Ogilvie formula (longhand)
      1. Each of the steps in the Ogilvie formula explained
   2. Ogilvie formula (shorthand)
      1. Mathematical proof demonstrating a simplified Ogilvie formula
      2. Download the simplified Ogilvie mathematical proof as a PDF here
   3. Ogilvie formula (oversimplified)
      1. Learn how to perform an Ogilvie calculation in your head in 5 minutes (PDF download)
   4. Ogilvie formula (18 point rule)
      1. Read the Ogilvie “18 point rule”
      2. Download the Ogilvie “18 point rule” as a handy PDF
2. Ogilvie Case Law
   1. Ogilvie v. WCAB I (en banc) 2/3/2009
   2. Ogilvie v. WCAB II (en banc) 9/3/2009
   3. Bowden v. Sunray Termite San Jose WCAB Panel Decision ADJ4536632
      • Commissioner Miller letter dated 1/13/2010 to Defense attorney on Bowden v Sunray Termite
   4. Shini v. Pacific Coast Auto Body & Truck San Diego WCAB Panel Decision ADJ2079252 (1/25/2010)
   5. Ochoa v. UPS Ground Freight Order Denying and Report and Recommendation on Reconsideration ADJ1758338 (2/8/2010)
   6. Bertha Noriega Garcia v. Patrick L. Hinrichsen WCAB Panel Decision ADJ6721939 (3/1/2010)
3. Litigating Ogilvie
   1. Argonaut Ins. Co. v. Ind. Acc. Com. (Montana) (1962) 57 Cal.2d 589
4. Applicant Attorney Ogilvie Handbook
5. Defense Attorney Ogilvie Handbook
6. Appendix
   1. EDD Labor Market Information Division
   2. Cal. Labor Code § 4651 “Average annual earnings shall be taken as fifty-two times the average weekly earnings referred to in this chapter.”

Sample Ogilvie DFEC analysis brief, complete with citations, explanations, and exhibits

Almarez/Guzman: Full steam ahead

Yesterday the 6th Appellate District of the California Court of Appeal issued a Writ of Review, denied Defendants’ request for a stay, and indicated that the matter would be set for oral argument. [1]  If you would rather just read what they have to say, here it goes:

Petitioner’s request for a stay is denied. Petitioner’s request for judicial notice, filed on 10/16/09 is denied. The petition for writ of review is granted as follows: Let a writ of review issue ordering the WCAB to certify & return to this court is official record in Guzman v. Milpitas Unified School District & Keenan & Associates, WCAB case No. ADJ3341185 (SJO0254688), not later than 3/25/10. Respondents may file opposition on 3/25/10. Petitioners my reply to the opposition in 20 days after the opposition is filed in this court. The matter will be placed on calendar at a time & place to be specified by court order. Any party desiring oral argument shall so inform this court in writing on 3/25/10 by completing & returning to this court the attached “request for oral argument” form (P, E, WD)

What does this mean for you?  Well, it means at least another four months of Almarez/Guzman II.

The fastest I recall a case going from the granting of a Writ of Review to to Order after oral argument was about four months.  In that case (Rollick) the Court of Appeals had basically already made up their minds about the issues and had allotted each side 10 minutes of argument.  The oral argument in that case took place about four months after the Writ was granted and Order issued almost immediately after argument.  However, the issues presented by Almarez/Guzman II are considerably more intricate.

For more analysis on this decision check out the article on WCExec!

1. Photo courtesy of jjjohn.

Also not a valid permanent disability rating schedule for 2009

I’ve been getting a lot of questions about the Draft 2009 Permanent Disability Rating Schedule.  There is no 2009 Permanent Disability Rating Schedule. [1]

Yes, yes, I know we’re supposed to have a new schedule per 8 CCR 9805, but the proposed draft 2009 PDRS was never approved.

Overall, the draft 2009 Permanent Disability Schedule doesn’t change much from the existing 2005 schedule.  The biggest change is in the application of the FEC rank adjustment.  Instead of increasing permanent disability between 10% and 40%, the proposed FEC rank system would increase permanent disability between 20% and 50%.  Additionally, the proposal suggested juggling the various ranks among the body regions.  If you’re curious about the exact proposed changes, the DWC Newsline gave a really great overview back on May 9, 2008.

Here’s the take-away:

• The 2009 Draft Permanent Disability Rating Schedule was not approved.
• The only official schedule for injuries on or after 1/1/2005 is the current 2005 Permanent Disability Rating Schedule.
• The DEU’s own webpage, updated on 10/2009 as of the date of this posting, doesn’t even offer a link to the 2009 draft schedule.

1. Photo courtesy of wenzday01

WCAB gives Ogilvie the green light

Apparently the defense attorney on Bowden v Sunray Termite wrote ex parte to the WCAB requesting the case be declared a significant panel decision. [1]

Commissioner Miller’s letter (download below) notes Bowden was a “purely fact driven case” and “is not to be a statement of legal importance to the community.”  Commissioner Miller further points out Significant Panel decisions are citable panel decisions but not binding legal precedent. [2]

What does this mean to you?

Ogilvie has not been stayed, so sharpen your #2 pencils and work on your math skills.

1. Photo courtesy of adamwilson
2. Even if the defense attorney’s request had been granted Ogilvie, as an en banc decision, would still take precedence over Bowden.

This sign is ALSO not a stay on Ogilvie

I’m still getting e-mails suggesting that Bowden v. Sunray Termite is a WCAB Panel decision staying Ogilvie. [1]  Thanks to some loyal readers, I now have a copy of this Panel decision:

1. Photo courtesy of loop_oh

Just a red herring

In a word, no.  Ogilvie has not been stayed by the WCAB, Court of Appeals, or any other court at this time. [1]

A defense attorney is circulating a letter suggesting that he got the Board to agree on Reconsideration to stay the application of Ogilvie on a case until the Supreme Court decides on the issue.

First, let me preface by saying the Board might theoretically decide to not apply the DFEC rebuttal analysis under Ogilvie for any number of reasons:

• Perhaps the defense vocational expert witness was particularly persuasive
• Perhaps the injured worker was a terrible witness
• Perhaps the Board noted a particularly disproportionate effect of Ogilvie
• Perhaps there were a lot of “motivational” issues for the injured worker
• Perhaps the injury was less than 3 years old

Secondly, even if the Board found a way to decline to apply the DFEC rebuttal analysis under Ogilvie in one circumstance, this does not stay or overrule Ogilvie.  We would need to see something from either the Court of Appeals or another[2] en banc Ogilvie decision from the WCAB.

Thirdly, while I have not seen the documentation to prove it, I have learned the Board declined to apply the DFEC rebuttal analysis under Ogilvie due to some technical issue not having much to do with the actual Ogilvie case.

So, to recap – Ogilvie has not been stayed.  If someone claims otherwise, ignore them until they produce the case.  And when you see it… send me a copy!

1. Photo courtesy of jypsygen
2. Third!!!

Double dippin' done right

Some commentators have suggested that the recent Duncan v. WCAB (X.S.) case creates a “double dip” for injured workers entitled to permanent total disability benefits. [1]  While I would take issue with much of that commentary, I would agree that permanent total disability benefits are affected by changes in the state average weekly wage twice under Duncan v. WCAB (X.S.).  Of the four benefits in California workers’ compensation system that are affected by changes in the SAWW, only permanent total disability benefits are affected twice.

It took the patient guidance of a very smart friend to help me to understand how this works:

• When determining the proper starting rate for a permanent total disability case, you must first turn to Cal. Labor Code § 4453(a)(10).  This statute dictates that the limits (as in the statutory minimum and statutory maximum limits) are to be increased by the increase in the state average weekly wage (or SAWW).
• However, according to Cal. Labor Code § 4659(c) as interpreted by Duncan v. WCAB (X.S.), the benefit rates themselves are then increased by the increase in the state average weekly wage (or SAWW).

Is it “double dipping” to have both the upper/lower limits and benefit rates increased by the SAWW?

Perhaps, but that’s what the two statutes say and what the Court of Appeals has decided.

1. Photo courteys of _Bonnie_

Getting a handle on the SAWW

Four benefits in California workers’ compensation are affected by changes in the state average weekly wage (or SAWW).[1]

1. Temporary total disability benefits
   • The maximum and minimum benefit rates can be affected by the SAWW.
   • “Commencing on January 1, 2007, and each January 1 thereafter, the limits specified in this paragraph shall be increased by an amount equal to the percentage increase in the state average weekly wage as compared to the prior year.”  Cal. Labor Code § 4453(a)(10).
2. Life pension benefits
   • The statutory life pension rates are now increased by the SAWW as directed by the recent Duncan v. WCAB (X.S.) case.
   • “For injuries occurring on or after January 1, 2003, an employee who becomes entitled to receive a life pension or total permanent disability indemnity as set forth in subdivisions (a) and (b) shall have that payment increased annually commencing on January 1, 2004, and each January 1 thereafter, by an amount equal to the percentage increase in the “state average weekly wage” as compared to the prior year.”  Cal. Labor Code § 4659(c).
3. Permanent total disability benefits
   • First, the minimum and maximum limits for permanent total disability benefits are increased, then the benefit rates themselves are increased.
   • “Commencing on January 1, 2007, and each January 1 thereafter, the limits specified in this paragraph shall be increased by an amount equal to the percentage increase in the state average weekly wage as compared to the prior year.”  Cal. Labor Code § 4453(a)(10).
   • “For injuries occurring on or after January 1, 2003, an employee who becomes entitled to receive a life pension or total permanent disability indemnity as set forth in subdivisions (a) and (b) shall have that payment increased annually commencing on January 1, 2004, and each January 1 thereafter, by an amount equal to the percentage increase in the “state average weekly wage” as compared to the prior year.”  Cal. Labor Code § 4659(c).
4. Death benefits
   • “A death benefit in all cases shall be paid in installments in the same manner and amounts as temporary total disability indemnity would have to be made to the employee, unless the appeals board otherwise orders.” Cal. Labor Code § 4702(b).

Did I just describe two increases to the permanent total disability benefit rate?  Huh, so I did.

Tune in tomorrow for more on Duncan v. WCAB, COLA’s, and SAWW increases!

1. Photo courtesy of Sean Venn

Putting some teeth in the SAWW

We’ve all seen charts with the State Average Weekly Wage (“SAWW”) increases printed on them.[1] But, how useful are these when you’re dealing with an opposing counsel who won’t accept your chart or calculations based on that chart?

It sure would be nice to have all the SAWW information from the Division of Workers’ Compensation all in once place.  Well, it just so happens I’ve already done this for you.

Here is a copy of every DWC Newsline from 2003 through 2009 with information on every SAWW increase from 2004 through 2010, all ready to go in one handy-dandy PDF.

Share and enjoy!

More on Duncan v. WCAB, COLA’s, and SAWW increases tomorrow!

(Don’t forget to download a copy of Duncan v. WCAB here!)

1. Photo courtesy of Aeioux

Mini version of Duncan v. WCAB

In the spirit of my recent post summing up Ogilvie II and Almaraz/Guzman II in just three sentences each, I bring you a summary of the recent Duncan v. WCAB decision in just one sentence:[1]

The COLAs found in section 4659, subdivision (c) should be applied to life pensions or total permanent disability compensation as from January 1, 2004.[2]

Yes, that’s really it.  The Duncan decision consists mostly of background and discussion.  The actual decision is basically that one line above.

Come back tomorrow for more information about SAWW increases, COLA calculations, and more!

(Don’t forget to download a copy of Duncan v. WCAB here!)

1. Photo courtesy of MarkAllanson
2. Duncan v. WCAB, page 18.

If you can use duct tape, you can perform an Ogilvie DFEC analysis in 5 minutes

An Ogilvie / DFEC analysis isn’t really difficult, especially when this website has a free Ogilvie / DFEC calculator.[1] The problem comes when you have to prove all the math behind those calculations.  This involves “showing your work.”

The best way to “show your work” is to take the reader through each step of the Ogilvie analysis.  I’ve prepared a sample report (generated using a new service on this website) which provides a clear and easy to understand format for “showing your work.”

The steps are basically this:

• Step 0:  2005 PDRS rating string
• Step 1: Post-Injury Earnings of Applicant
• Step 2: Post-Injury Earnings of Similarly Situated Employees
• Step 3: Calculate Proportional Earnings Loss
• Step 4: Calculate Individualized Rating to Loss Ratio
• Step 5: Compare Individualized Rating to Loss Ratio to range of ratios for the FEC ranks

For those interested, here’s a more detailed explanation of each step in an Ogilvie / DFEC analysis.

When each step of the Ogilvie / DFEC analysis is stated clearly, the reader can see every assumption, step, and perform their own calculations to verify your conclusions.  As long as the parties agree on the numbers used in an Ogilvie / DFEC calculation, they should always arrive at the same result.

Setting forth every single step of your Ogilvie / DFEC analysis lets you to spend less time arguing about the impact of Ogilvie and more time trying to get the case settled.

1. Photo courtesy of indigotimbre