Jun
27
2009
0

Guest Article: Vocational Expert Response to Ogilvie/Almaraz/Guzman

The workers compensation law is founded on the concept of exclusive remedy. In exchange the employer is protected from a civil case. The agreement results in liberal construction. The Trier of Fact has always had the latitude to interpret PD when there are gray areas, and can do so in favor of the worker. The traditional concept is that this is a David and Goliath situation and the system should err in favor of the injured workers.

The new En Banc decisions are a recapitulation of this basic tenet of all workers compensation law. We first saw this in Le Bouef, followed by any number of cases where a PD rating is increased by the WCAB. In cases like Espinoza in the late 80’s, literacy was factored out of the PD rating and considered non industrial. This came up again recently in Hertz, but its really old news.

The new En Banc decision has given the applicant’s attorney more encouragement to challenge the rating. There has always been this ability and the challenge is generally successful, if in fact, the worker is far more disabled than rated. Or far less. I recall the excitement when a case law came out in the late 90’s that said the PTP did not always prevail. The judge simply found the D/QME better science, better clinical evidence and more compelling than a poorly conceived PTP report.

The use of the vocational expert in cases where there is a possible injustice has always been an option for the applicant attorney. The defense will need rebuttal evaluations to ensure that these assertions are fairly reviewed by the Trier of Fact. I am pleased to see the issue raised and the heightened interest in the opinions of vocational experts. There are many pitfalls in the practices and methodologies used. Does interest and motivation factor into ability to work? Is possible to identify the “highest and best” earnings and the “lowest and worst?” Certainly a decent vocational expert can take any side of the argument and present a case of very low, or no earnings, or present a case of higher earnings or no loss of earnings. These are hypothetical evaluations, and the factors must be considered carefully.

Recently I evaluated a young man, age 27, who had an injured hand and could no longer deliver furniture. He was earning $16.00 per hour. The applicant’s evaluator determined he had no transferable skills and was able to earn only minimum wage. One year later, the applicant had taken a four week course in phlebotomy and was earning $22.00 per hour, an increase in earning capacity. The software used by vocational experts would never have predicted this outcome. I did however; predict it, as it turned out that the worker had 100 undergraduate units, but no degree. I asserted that with that level of aptitude for learning, he would eventually find his highest and best earning capacity. The evaluation which is limited to D.O.T codes will be open to scrutiny and can be overturned. Only by consideration of all rehabilitation factors is it possible to accurately predict earning capacity.


To contact Emily Tincher, call 415 389 8953 or email her at Emily.tincher@cascadedisability.com.

Emily Tincher is a vocational expert, in practice over 25 years throughout California, as a specialist in workers compensation. She has a Masters in Vocational Rehabilitation Counseling from the CRC certified program at University of Southern California, and was admitted to the American Board of Vocational Experts as a Fellow.
May
11
2009
0
May
11
2009
0

Ogilvie, Almaraz/Guzman Amicus Briefs

Appeal (get it?)

Appeal (get it?)

Thanks to our friends at AppealsBoardReporter.com, we now have access to 22 amicus briefs filed in the Ogilvie and Almaraz/Guzman cases. 1 In late March 2009 the WCAB granted reconsideration of their recent Ogilvie and Almaraz/Guzman decisions – and invited the submission of amicus briefs.  You can read and download them here:

Who produced them?  Well, Ogilvie amicus briefs were filed by:

  • Morrow & Morrow
  • International Association of Rehabilitation Professionals
  • The Travelers Companies Inc.
  • Insurance Commissioner Steve Poizner
  • California Workers’ Compensation Institute

The Almaraz/Guzman briefs were filed by:

  • California Applicants’ Attorneys Association
  • California Chamber of Commerce-CSAC Excess Insurance Authority
  • County of Los Angeles
  • California Self-Insured Employers Association
  • California Society of Industrial Medicine and Surgery
  • California Workers’ Compensation Institute
  • Department of Industrial Relations Director John Duncan
  • Employers Direct Insurance Company
  • Phil Walker, Esq.
  • Phil Walker, Judicial Notice Request
  • Protected Insurance Program for Schools
  • Insurance Commissioner Steve Poizner
  • Safeway Inc.-The Boeing Co.-Schools Insurance Authority
  • San Diego Schools Joint Powers Authority
  • International Association of Rehabilitation Professionals
  • Morrow & Morrow
  • The Travelers Companies Inc.

After reviewing the above list, I have to wonder: Why doesn’t CAAA have an amicus brief for Ogilvie?  Does anyone know?

  1. Photo courtesy of Black Glenn.  Terrible pun courtesy of me. []
Apr
06
2009
1

Ogilvie, Almaraz, & Guzman: Reconsideration Granted! Amicus Briefs Allowed!

Need more time to think about Ogilvie, Almaraz, and Guzman?

Need more time to think about Ogilvie, Almaraz/Guzman?

Sometimes even the WCAB needs more time to think.1

On March 26, 2009, the director of the Department of Industrial Relations, John C. Duncan, issued a letter to the entire Workers’ Compensation Appeals Board asking them to vacate their own decisions and solicit argument and amicus briefs.  Here’s a copy, courtesy of WCExec.com, the Letter from Director of DIR to WCAB re: Ogilvie and Almaraz/Guzman (3/26/2009).

On Monday April 6, 2009 the WCAB issued three Orders Granting Reconsideration and Order Allowing Amicus Briefs (en banc) in Ogilvie and Almaraz/Guzman.  For your review:

What does the Order Granting Reconsideration of Ogilvie and Almaraz/Guzman mean for you?

    1. Ogilvie and Almaraz/Guzman are still the law.  Despite Commissioner Aghazarian’s two concurring opinions, the WCAB did not issue a stay of either Ogilvie or Almaraz/Guzman.
    2. The WCAB has granted SCIF’s petition for reconsideration in Almaraz, granting reconsideration on their own motion in Guzman, and the parties’ petitions for reconsideration in Ogilvie.  They have granted reconsideration on these cases to, “afford us a sufficient opporutnity to study the issues.”2
    3. Any interested party may file an amicus brief no later than May 1, 2009 at 5pm.
      1. Photo courtesy of radiospike photography []
      2. Hence, the “The Thinker” reference above… []
      Mar
      23
      2009
      0

      How has Almaraz/Guzman changed workers’ compensation?

      AMA Guides 5th Ed.

      AMA Guides 5th Ed.

      Clearly, Almaraz/Guzman has been a boon to the U.S. Postal Service.  I’ve been receiving Almaraz/Guzman letters from Applicant attorneys on my files ever since the en banc decision came out.  These letters typically fall into one of three categories:

      1. Increased demands for settlement
      2. Demands for additional discovery per Almaraz/Guzman
      3. Letters to the PQME/AME requesting their opinions on impairment outside the AMA Guidelines to the Evaluation of Permanent Impairment, Fifth Edition

      I’ve also heard of some doctors completely abandoning the AMA Guidelines to the Evaluation of Permanent Impairment, Fifth Edition, in favor of just analogizing impairment.  This is not what was intended by the en banc panel in WCAB in Almaraz/Guzman.

      Here’s what Almaraz/Guzman means for workers’ compensation practitioners:

      So, remember:

      1. Whether you agree with the AMA Guides or the 2005 PDRS they’re still the law of the land and must be addressed.
      2. Whether you agree with Almaraz/Guzman, it’s still good law and must be addressed.
      3. Almaraz/Guzman does not absolve a doctor from the responsibility to generate a medical report which addresses the AMA Guides and constitutes substantial medical evidence.

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