According to a recent poll of businesses on compliance issues, workers' compensation ranks as one of the most complicated set of laws, right up there with the tax code. In California this problem wasn't made any easier when the state legislature adopted the American Medical Association's Guides to the Evaluation of Permanent Impairment, Fifth Edition, to determine the extent to which an injured worker is permanently disabled. There's a steep learning curve for physicians, attorneys, and judges using the AMA Guides.

Some of the most controversial issues surrounding the use of the AMA Guides deal with apportionment and risk factors (e.g., genetics, age, gender, family history, race, national origin, life-style choices), spinal injury cases, muscle strength deficits, chronic pain, and sleep disorders. Robert G. Rassp, author of The Lawyer's Guide to the AMA Guides and California Workers' Compensation deconstructs the Guides, chapter by chapter, and puts everything in plain English for both the initiated and uninitiated. To order his book, Click Here.  

The majority of states use the Fifth Edition of the AMA Guides, while others use the Fourth or Third Edition. Although Texas uses the Fourth Edition (the Commissioner may adopt subsequent editions by rule), experts expect a showdown in the state during the next few years before the Guides are fully accepted there. Other states like New York and Florida have their own impairment rating systems and don't use the AMA Guides. South Carolina, which recently enacted major workers' compensation reforms, decided that the Guides can wait, so they stripped out any mention of the Guides since it had become a point of controversy and debate and could've held up passage of the reforms.

The word out there is that the Sixth Edition of the AMA Guides, available in November, will stir up more controversy. Even some of the authors of the Fifth Edition declined to participate on the Sixth Edition. They say that the Fifth Edition explains the Fourth Edition. The Fifth Edition, however, reportedly contains something like 90 medical errors. Will the Sixth Edition, then, explain the Fifth Edition?