Arizona Noteworthy Cases Interpreting the AMA Guides to the Evaluation of Permanent Impairment – Sixth Edition

Arizona Noteworthy Cases Interpreting the AMA Guides to the Evaluation of Permanent Impairment – Sixth Edition

In this Emerging Issues Analysis, Thomas A. Robinson analyzes noteworthy cases from Arizona that interpret the AMA Guides to the Evaluation of Permanent Impairment. Robinson initially explains that the Arizona “Workers' Compensation Act divides permanent disabilities into two broad categories: those compensated under a fixed schedule (scheduled disabilities), compensable under Ariz. Rev. Stat. § 23-1044(B), and those compensated according to actual loss of earning capacity (unscheduled disabilities), Ariz. Rev. Stat. § 23-1044(B). A disability otherwise within the schedule may nevertheless be treated as unscheduled if the injured worker had a previous disability, Ariz. Rev. Stat. § 23-1044(E), if an industrial injury causes multiple scheduled injuries, or if the residual effect of an industrial injury extends beyond the scheduled impairment. Arizona utilizes the Sixth Edition of the AMA Guides by virtue of Arizona Admin. Code [A.A.C. § R20-5-113(B)], which provides in relevant part that when a physician discharges a claimant from treatment, the physician:
  1. Shall determine whether the claimant has sustained any impairment of function resulting from the industrial injury. The physician should rate the percentage of impairment using the standards for the evaluation of permanent impairment as published by the most recent edition of the American Medical Association in Guides to the Evaluation of Permanent Impairment, if applicable; and
  2. Shall provide a final signed report to the insurance carrier, self-insured employer, or special fund division that details the rating of impairment and the clinical findings that support the rating.”
 
He examines in detail cases dealing with the following:
  • Case Involving Injury to Arm.
  • Cases Involving Injury to Leg.
  • Case Involving Injury to Wrist.
  • Cases Involving Other Issues.
 
 
 This article is excerpted from the new AMA Guides volume of Occupational Injuries and Illnesses (Matthew Bender) (to be published October 2009). This volume on the AMA Guides is intended to help attorneys, claims adjusters, and other personnel apply the AMA Guides to individual cases. Because most insurance law and workers’ compensation law is statutorily-derived and cases are adjudicated at the state level, it is important to be familiar with the impairment rating system used in each practitioner’s state. States have different philosophies, public policies, and laws regarding the use and application of the AMA Guides to individual claims administered in that state. To that end, this Volume attempts to capture court cases that have addressed the use of the AMA Guides methodology and impairment rating system, specific to each state.