Workers' Compensation: AMA Guides: Ask the Expert: Robert G. Rassp, Esq.

AMA Guides

8/11/2008 5:24:55 PM EST

Ask the Expert: Robert G. Rassp, Esq.

Posted by LexisNexis Workers' Compensation Law Center Staff

Ask the Expert

Featured Expert
Robert G. Rassp, Esq.
Topic: AMA Guides & Calif. workers' compensation

If you have a question about the AMA Guides and how it interacts with California workers' compensation law, simply logon and submit a comment to this post. Our expert will respond within a reasonable time to your question. If you have any problems with registration or logging on, please contact the site coordinator at Robin.E.Kobayashi@lexisnexis.com.

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About the Expert. Robert G. Rassp, Esq. has practiced workers' compensation and Social Security disability law since 1981 and is the principal of his own law firm since 1983. He has conducted workers' compensation judge's training seminars on the AMA Guides at the request of the Division of Workers' Compensation. He is the author of The Lawyer's Guide to the AMA Guides and California Workers' Compensation (LexisNexis Matthew Bender) and is a frequent speaker at State Bar seminars and other conferences.

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Comments
Zooey Last Post: 8/18/2008 9:06:44 PM	Subject: Ask the Expert: Robert G. Rassp, Esq. Date Posted: 8/18/2008 9:06:44 PM
Zooey Last Post: 8/18/2008 9:06:44 PM	The AMA Guides seem to indicate that where a spinal injury is not the result of a specific incident (accident), but rather a disease process or cumulative trauma, the best method for evaluation of disability is the ROM (range of motion) method. DEU raters, however, seem to apply the DRE method. What is your interpretation of this aspect of the Guides? Create an account or login to post comments.
RobertGRassp1 8/22/2008 4:44:24 PM subject: response to Zooey The determination by the DEU rater is not binding on the parties -- the judge has the ultimate authority to determine permanent disability under the WCAB Rules of Practice and Procedure section 10602. The physician needs to state which method, DRE or ROM, properly applies in a given case and why. The judge will have to review the actual language in the AMA Guides on pages 379-381 and Table 15-7 to see how to resolve any disputed language in those locations and which method applies in a given case.
Esmee Last Post: 8/19/2008 3:27:24 PM	Subject: Ask the Expert: Robert G. Rassp, Esq. Date Posted: 8/19/2008 3:27:24 PM
Esmee Last Post: 8/19/2008 3:27:24 PM	How may physicians justify opinions that vary from the strict provisions of the AMA Guides? Create an account or login to post comments.
RobertGRassp1 8/22/2008 4:50:23 PM subject: response to Esmee Physicians are obligated under Labor Code Section 4660(b)(1) to use the descriptions and measurements of the AMA Guides. They cannot write conclusions based upon how they feel about the use of the AMA Guides. That being said, the physician must apply the Guides in a given case appropriately by using the actual tables, figures, and text in the Guides. How the tables, figures and text language applies is subject to broad interpretations by physicians -- there is no correct answer on how a given table, figure or text applies across the board. Physicians are encouraged to quote the actual language from the tables, figures and text and to explain how and why the particular language applies in a case.
MHeffernan Last Post: 8/24/2008 11:57:05 PM	Subject: Ask the Expert: Robert G. Rassp, Esq. Date Posted: 8/24/2008 11:57:05 PM
MHeffernan Last Post: 8/24/2008 11:57:05 PM	Are there cases in other states that are interpreting the AMA Guides and should judges and attorneys be reading those cases? Specifically, have you ever reviewed those cases in other states if California law and the AMA Guides are silent on a particular issue so you could see how other jurisdictions are addressing it? Create an account or login to post comments.
RobertGRassp1 8/25/2008 12:01:35 AM subject: response to MHeffernan Other states do not have Calif. Labor Code Section 3202 and none have the FEC adjustment. Most states that use the AMA Guides have a unique spin to their use by regulation or statute such as "You must use ROM in spinal cases and no DRE method." It would be meaningless to search for cases in other states that interpret the AMA Guides because of each state's nuances, including our own. I would like for us to develop our own "interpretations" of the AMA Guides without help from other states.
RudyK Last Post: 8/25/2008 2:01:16 PM	Subject: Ask the Expert: Robert G. Rassp, Esq. Date Posted: 8/25/2008 2:01:16 PM
RudyK Last Post: 8/25/2008 2:01:16 PM	Within the lower extremity chapter there is a table of impairment for antalgic gait disability. The Guides also include some verbiage and/or limitations regarding use of the table for various lower extremity injuries. So, for example, with a knee injury, there is a question as to whether or not the antalgic gait table can be used to rate impairment or whether the specific range of motion method can be used. What is your opinion about this? Create an account or login to post comments.
RobertGRassp1 8/25/2008 2:07:04 PM subject: response to RudyK The Guides indicate that the physician must use the method that best describes the impairment and is most specific. In a knee injury case you should use Table 17-2 to see if the physician evaluated all 13 methods of evaluating lower extremity reatings. Medically, an "antalgic gait" is not the same as "Gait derangement" which is ratable under Table 17-5. An antalgic gait is a symptom of a lower extremity or lumbar spine condition that affects a person's walking ability (e.g., limping) while a gait derangement refers to ratable impairment based upon the criteria in Table 17-5 and the text referring to it. The problem with most knee cases involving a torn meniscus is that there is very little residual impairments from them under Chapter 17. See DBE, Table 17-33 which is a 1% WPI regardless of the outcome of the knee surgery. Many physicians are failing to give a rating for an ACL repair or replacement under the ligament laxity section in Table 17-33 if the result is normal range of motion and no laxity. The physicians and everyone else forgets that the DBE method in Table 17-33 does not take into account the outcome of surgery. So a person with a meniscus tear and ACL repair would get two ratings, both from Table 17-33 that can be combined with each other and with any other ratings that apply in Table 17-2.
EMoniz Last Post: 10/28/2008 12:42:53 AM	Subject: Ask the Expert: Robert G. Rassp, Esq. Date Posted: 10/28/2008 12:42:53 AM
EMoniz Last Post: 10/28/2008 12:42:53 AM	Can sleep disorders really lead to higher ratings? Create an account or login to post comments.

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