Robert G. Rassp on Five of the Most Controversial Issues in AMA Guides and California Workers' Compensation Cases
Attorney, Law Offices of Robert G. Rassp
In order to get an accurate permanent disability rating for an injured worker in the California workers' compensation system, counsel needs to develop the record in all AMA Guides cases by reading the instructions in the AMA Guides and making sure physicians applied the descriptions and measurements in the Guides properly and consistently with those instructions and with the 2005 Permanent Disability Rating Schedule.
This article, written by California workers’ compensation and social security attorney Robert G. Rassp, discusses five of the most controversial issues in AMA Guides cases, the resolution of which may require judicial determinations and appellate law. These controversial issues are (1) apportionment, duplication, and overlap, and risk factors; (2) spinal injury cases (DRE vs. ROM), (3) muscle strength deficits; (4) complex regional pain syndrome and chronic pain, and (5) sleep disorders. (Note: This article is excerpted from the 2008 Edition of The Lawyer's Guide to the AMA Guides and California Workers' Compensation (LexisNexis Matthew Bender).)
According to Mr. Rassp, the discussion of these issues may give practitioners some skills in how to develop the record so that an accurate rating can be established in a case. Regarding the apportionment issue, which is one of the most highly controversial issues at this time in California workers' compensation law, Mr. Rassp states that the important point here is that even the authors of the AMA Guides mandate the individualization of each person's impairment rating. Calif. Labor Code § 4660 mandates that the state utilize a uniform, objective, and consistent method of rating industrial injuries.
What is clear from reading AMA Guides Chapters 1 and 2 is that the only thing that is “uniform, objective and consistent” as mandated by the Calif. Labor Code is the actual use of the AMA Guides. But once practitioners open the Guides and use its pages in a given case for a given applicant, any uniformity, objectivity or consistency is discarded in favor of both individualizing a person's impairment rating based in part on the effects of the impairment on that person's activities of daily living (ADLs) and individualizing apportionment of impairments to “other factors” if appropriate.
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