Sep
04
2009
1

Ogilvie II, Almaraz/Guzman II – Reader Digest Versions

Ogilvie and Almaraz/Guzman - lets cut to the chase

Ogilvie and Almaraz/Guzman - let's cut to the chase

First off, if you haven’t already downloaded Ogilvie II and Almaraz/Guzman II, do so now!

As I mentioned previously, each of these cases is about 50 pages long, so there is clearly no substitute for reading them for yourself.  However, here’s Ogilvie II and Almaraz/Guzman II in five sentences:[1]

  • Ogilvie v. WCAB II:
    • The WCAB ruled the original Ogilvie (I) formula is still valid.
    • The WCAB appears to have created a right to reopen a case for “individualized proportional earnings loss.”
    • Vocational testimony is not an appropriate way to dispute the DFEC portion of the 2005 Permanent Disability Rating Schedule.
    • (Bonus Dissent Summary: The lone dissent by Caplane says that vocational testimony should be considered proper rebuttal to an entire permanent disability rating.)
  • Almaraz/Guzman II:
    • The WCAB ruled that a doctor must issue reports within the “four corners” of the AMA Guides 5th Edition to comply with Labor Code Section 4660(c). [2]
    • However, either party may obtain rebuttal evidence in the form of supplemental reports and depositions regarding the use of any other chapter, method, or table within the AMA Guides.
    • (Bonus Dissent Summary:  The dissenting opinion from Brass, Caplane, and Moresi says they would affirm their decision in Almaraz/Guzman I.)

What do these cases mean for the practitioner?

  • The WCAB has created a new right to reopen for a higher than expected “individualized proportional earnings loss.”
  • The Ogilvie Mathematical Proof of 18 Point Add-Ons still stands.
  • I see even more doctor depositions in my future.
  • My phone is going to be ringing off the hook tomorrow.
  1. Photo courtesy of Scallop Holden []
  2. Here, the phrase “four corners of the AMA Guides” just means the parties are restricted to the actual text of the AMA Guides and cannot use analogies and evidence from outside the AMA Guides. []
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.
Feb
16
2009
1

Combined Values Chart

Combined Values Chart for the 2005 PDRS

Combined Values Chart for the 2005 PDRS

A few weeks ago I posted about the Multiple Disabilities Table for combining disabilities with injuries prior to 2005.

For injuries after 2005 we must turn to the 2005 Permanent Disability Rating Schedule.  When combining disabilities for injuries after 2005 there are several possible alternatives.  You can:

  1. In case you’re wondering, the chart on the right is a super-condensed version of the Combined Values Chart on pages 8-2 through 8-4. []
  2. Honestly, I don’t recommend this.  It wasn’t fun. []

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