I recently delivered a presentation about apportionment in light of the Viara, Benson and Sierra Bible cases at the recent CSIMS 2008 Mid Summer Seminar, June 11-15, in beautiful La Jolla, CA.

I proposed a five-step apportionment analysis based upon Escobedo. In essence, if the physician cannot answer any one of the five questions below in the affirmative, then no apportionment is warranted and the current level of disability presented at the time of evaluation is 100% industrial. The five questions for physicians are:

1. Injury AOE/COE - yes or no? If no, stop.

2. Did the injury cause any impairment as described by the AMA Guides? If no, stop.

3. If the industrial injury did cause impairment, what is the extent of the current level of impairment presented to your office at the time of evaluation? If none, stop.

4. Are other factors, besides the injury alleged, causally responsible for any part of the current level of residual impairment presented? If no, stop.

5. If you conclude that there are other factors contributing to the employee’s current level of disability, the 5th question asks you to identify the causal percentage of the past act, or acts, that are responsible for the current level of impairment. If you cannot present a medical opinion that constitutes substantial evidence regarding the percentage of causation that any other acts may have had upon the current level of disability, then you should stop your analysis and there is no apportionment.

For further information about the California Society of Industrial Medicine and Surgery, click here.