Ch. 1 How to Use This Guidebook
§ 1.01 Purpose and Organization of This Guidebook
§ 1.02 AMA Guides—Frequently Used Terms
§ 1.03 AMA Guides—Common Acronyms
§ 1.04 AMA Guides—Common Medical Conditions by AMA Guide Chapter

Ch. 2 Permanent Disability Ratings Under SB 899 and SB 863
§ 2.01 The Effects of Reform Legislation
[1] SB 863
[2] SB 899
§ 2.02 Overview of 2005 Permanent Disability Rating Schedule
[1] Organization of 2005 PDRS
[2] Comparison to 1997 Rating Schedule
[3] Basic Components of 2005 PDRS
[4] Multiple-Step Process for Determining Permanent Disability
[5] Commentary on Any New PDRS
[6] Calculating Permanent Disability for Injuries On or After 1/2/2013
§ 2.03 Application of AMA Guides to California Workers’ Compensation Cases
§ 2.04 Compliance of Medical Reports With Requirements of AMA Guides
§ 2.05 Pain Adjustments
§ 2.06 Psychiatric Injuries
[1] Generally
[2] Ratings
[3] Apportionment of Psychiatric Injuries
[4] Informal Ratings and Formal Rating Instructions in a AMA Guides Cases
§ 2.07 Model Joint AME and Panel QME Letters
[1] Introduction
[2] Advocacy Letters
[3] Joint AME Letters
[4] Joint PQME Letters
[5] Required Elements in a AMA Compliant Medical Report
[6] Templates for Letters

Ch. 3 AMA Guides: Chapter-by-Chapter Analysis
§ 3.01 Introduction
§ 3.02 AMA Guides Chapter 1: Philosophy, Purpose, and Appropriate Use of the Guides
§ 3.03 AMA Guides Chapter 2: Practical Application of the Guides
§ 3.04 AMA Guides Chapter 3: The Cardiovascular System: Heart and Aorta; Chapter 4: The Cardiovascular System: Systemic and Pulmonary Arteries
§ 3.05 AMA Guides Chapter 5: The Respiratory System
§ 3.06 AMA Guides Chapter 6: The Digestive System
§ 3.07 AMA Guides Chapter 7: The Urinary and Reproductive Systems
§ 3.08 AMA Guides Chapter 8: The Skin
§ 3.09 AMA Guides Chapter 9: The Hematopoietic System
§ 3.10 AMA Guides Chapter 10: The Endocrine System
§ 3.11 AMA Guides Chapter 11: Ear, Nose, Throat, and Related Structures
§ 3.12 AMA Guides Chapter 12: The Visual System
§ 3.13 AMA Guides Chapter 13: The Central and Peripheral Nervous System
§ 3.14 AMA Guides Chapter 14: Mental and Behavioral Disorders
§ 3.15 AMA Guides Chapter 15: The Spine
[1] Discussion and Analysis
[2] Checklist for Compliance of Medical Report on Spinal Injuries
[3] The "DRE Gap"
[4] Other Medical-Legal Issues in Spinal Injury Cases
§ 3.16 AMA Guides Chapter 16: The Upper Extremities
[1] Overview
[2] ROM Measurements
[3] Peripheral Nerve Disorders
[4] Digital and Hand Impairments
[5] Carpal Tunnel Syndrome
[6] Complex Regional Pain Syndrome
[7] Vascular Disorders
[8] “Other Disorders”
[9] Combining Upper Extremity Ratings for the Same Part of Body
[10] Checklist for Evaluating Upper Extremity Impairments
[11] FEC Adjustments
§ 3.17 AMA Guides Chapter 17: The Lower Extremities
[1] Overview
[2] 13 Methods of Evaluation
[3] Gait Derangement
[4] Atrophy
[5] ROM Testing
[6] Multiple Lower Extremity Impairments
[7] Arthritic Conditions
[8] Amputations
[9] Diagnosis Based Estimates
[10] Peripheral Nerve Injuries
[11] Complex Regional Pain Syndrome
[12] Peripheral Vascular Disease
[13] FEC Adjustment
§ 3.18 AMA Guides Chapter 18: Pain
§ 3.19 Pain Add-on for Sleep Disorders, Sexual Dysfunction and Psyche as Compensable Consequences of Physical Injuries

Ch. 4 Substantial Medical Evidence in a AMA Guides Case
§ 4.01 Model Sequential Step Analysis
§ 4.02 Substantial Evidence Defined
§ 4.03 AMA Compliant Reports
[1] Defined
[2] Required Elements
§ 4.04 The Good, the Bad, and the Ugly: Examples of AMA Compliant and Non-AMA Complaint Medical Reports
[1] In General
[2] Example #1: Lumbar Spine Impairment Rating
[3] Example #2: Upper Extremity (Left Wrist) Impairment Rating
[4] Example #3: Multiple Orthopedic Impairment Ratings
[5] Example #4: Upper Extremity (Shoulders, Wrists, Elbow) Impairment Rating
[6] Example #5: Lumbar Spine, Thoracic Spine, and Hip Impairment Ratings
[7] Example #6: Lower Extremity (Patella Fracture) Impairment Rating
[8] Example #7: Head Injury Impairment Rating

Ch. 5 Developing the Record to Establish Accurate Ratings Under the AMA Guides
§ 5.01 Introduction
§ 5.02 Justification for Use of the Guides in Workers' Compensation Cases
§ 5.03 Development of the Record Using AMA Guides Chapters 1 and 2
§ 5.04 Population Averages
§ 5.05 Age or Gender Related Impairments
§ 5.06 Apportionment, Duplication, and Overlap
§ 5.07 Risk Factors and Causation of Permanent Disability
§ 5.08 Use of Clinical Judgment
§ 5.09 Practical Applications of the Guides
§ 5.10 Measurements Must Be Reliable
§ 5.11 Assistive Devices
§ 5.12 Side Effects of Medication
§ 5.13 Spinal Injury Cases--DRE vs. ROM Methods
§ 5.14 Muscle Strength Deficits
§ 5.15 Complex Regional Pain Syndrome
§ 5.16 Chronic Pain Syndromes
§ 5.17 Failed Lumbar Syndrome
§ 5.18 Multiple System Impairments
§ 5.19 Sleep Disorders
[1] Introduction and Background
[2] Is Sleep Disorder Ratable?
[3] AMA Guides Discussion of Sleep Disorder
[4] Checklist for Sleep Disorder Claims
§ 5.20 Obstructive Sleep Apnea
§ 5.21 Fibromyalgia
[1] Introduction and Background
[2] Inconsistency in AMA Guides Regarding Fibromyalgia
[3] Is Fibromyalgia Ratable?
§ 5.22 Pain Add-Ons
§ 5.23 Zero Percent Impairment Ratings
§ 5.24 Headaches
§ 5.25 Between a Rock and a Hard Place: Permanent Total Disability Under labor Code § 4662

Chapter 6SA SB 863 Checklist & Reference Guide

Chapter 6 Application of AMA Guides and 2005 PDRS, and Effect of SB 863
§ 6.01 Introduction
[1] Overview of SB 863; Effective Date
[2] What Has Not Changed From SB 863
[3] What Is New Under SB 863 Related to Permanent Disability
[4] Adjustments for Occupation and Age
[5] Rebuttal of a WPI Rating
[6] Ogilvie Rebuttal for Injuries On or After 1/1/2013
[7] Payments of Permanent Disability
[8] No Change in Number of Weeks of Payments of Permanent Disability
[9] The 15% Bump-Up and Bump-Down
[10] Supplemental Job Displacement Benefits
[11] "Return to Work" Fund
[12] How to Do Ratings Under 2005 and 2013 PDRS
§ 6.02 Example 1: More Than One Body Part Injured in One Injury
§ 6.03 Example 2: Upper Extremity Injury and Its Sub-Regions
§ 6.04 Example 3: More Than One Body Part Injured in More Than One Injury
§ 6.05 Example 4: Failed Back Case With Psychiatric and Pain Sequelae
§ 6.06 Example 5: Voice/Speech Impairment
§ 6.07 Example 6: Recurrent Disc Herniation
§ 6.08 Example 7: Multiple Upper Extremity Injuries

Ch. 7 Case Summaries With Commentary
§ 7.01 Introduction
§ 7.02 Permanent Disability, Apportionment, and PDRS
§ 7.03 Applicability of 2005 PDRS to Injuries Prior to 1/1/2005
§ 7.04 Limitation of Compensability of Physical-Mental Disorder Based of Good Faith Personnel Actions

Ch. 8 Developing the Record and Rebutting the 2005 PDRS
§ 8.01 Overview § 8.02 Direct and Cross Examination of Applicants
[1] Introduction
[2] Applicant’s Deposition
[3] Other Deposition and Trial Considerations
§ 8.03 Direct and Cross Examination of Physicians
[1] Introduction
[2] Checklist of Questions in a AMA Guides Case
§ 8.04 Medical Questions on Pathology
§ 8.05 Rebutting the 2005 PDRS - Before Almaraz-Guzman and Ogilvie Cases
[1] Whether Extrinsic Evidence Is Allowed
[2] Proper Foundation Needed for Expert Testimony
[3] Vocational Expert Testimony
[4] Evidence of Loss of Future Earning Capacity
[5] Costs of Expert Testimony and Vocational Testing
[6] Procedural Considerations
§ 8.06 Almaraz-Guzman and Ogilvie WCAB En Banc Decisions
[1] Introduction
[2] Factual Background
[3] Almaraz-Guzman I and II
[4] Ogilvie I, II and III
[5] Practice Tips
§ 8.07 Rebutting a WPI Rating - Post Almaraz-Guzman II
§ 8.08 Rebutting a Strict Impairment Rating Based on the AMA Guides
[1] Introduction
[2] Grounds for Rebuttal
§ 8.09 Example #1: Lower Extremity Cases and table 17-2, The Cross-Usage Chart
§ 8.10 Example #2: Ferras v. United Airlines—Adductor Tendon Tear
§ 8.11 Example #3: Four Objective Finding, But Only One Ratable Impairment—Knee Injury
§ 8.12 Example #4: Rotator Cuff Tears, Shoulder Impingement Cases, Elbows, Any Upper Extremity Joint Involvement
§ 8.13 Example #5: Fractured Elbow With Avascular Necrosis and Contracture
§ 8.14 Example #6: Injured Worker Has Lost Significant Function in One or Both Upper Extremities Due to Multiple Impairments
§ 8.15 Example #7: Carpal Tunnel Syndrome as the Only Diagnosis
§ 8.16 Example #8: Muscle Strength Loss, Loss of Motion and Resection Arthroplasty for Shoulder
§ 8.17 Example #9: Various Ways to Rebut Strict Spinal Impairment Ratings
§ 8.18 Example #10: Reactive Airway Disease as a Result of Exposure to Fumes
§ 8.19 Example #11: Recurrent Back Sprains
§ 8.20 Example #12: Carpenter's Close Encounter With Table Saw

Chapter 9 Medical Information Every Lawyer and Judge Should Know
§ 9.01 Introduction
§ 9.02 Peer Review Defined
§ 9.03 Residual Functional Capacity
§ 9.04 Medical Resources
§ 9.05 Medical Glossary
§ 9.06 Medical Information
[1] Overview
[2] The Shoulder
[3] The Knees
[4] The Spine
[5] Herniated Intervertebral Disc With Nerve Root Impingement
[6] Spinal Canal and Neural Foraminal Stenosis
[7] Spondylolisthesis
[8] Spondylolysis
[9] Spondylosis
[10] Fractures
[11] Zygoapophyseal Pain (Facet Joint Syndrome)
[12] X-rays, MRI and CAT Scans
[13] Discograms and Myelograms
[14] Failed Lumbar Syndrome
[15] Treatment in Chronic Pain Cases
[16] Wrist and Hand
[17] Other Upper Extremity Injuries—The Elbow
[18] Other Upper Extremity Injuries—The Thumb
[19] The Heart and Cardiovascular System
[20] Arrhythmias
[21] Coronary Artery Disease
[22] Hypertension
[23] Strokes
[24] Concussions—Traumatic Brain Injuries
[25] Diabetes
[26] Opiate Addiction and Dependency
[27] Prescription Medicine Therapy Management
§ 9.07 Medications
§ 9.08 Apportionment
[1] Inextricably Intertwined—Benson Revisited and the AMA Guides
[2]The Wilkinson Doctrine
[3] Labor Code § 4663(c)
[4] The Benson Decisions
[5] Benson and the AMA Guides
[6] Can a Risk Factor Become Causative?

APPENDIX A 2005 Permanent Disability Rating Schedule
APPENDIX B [Reserved]
APPENDIX C Permanent Disability Rates
INDEX

Robert G. Rassp, Esq., Editor-in-Chief

Robert G. Rassp, Esq. has practiced California workers' compensation and Social Security disability law since 1981 and is the principal of his own law firm since 1983. In addition to his law practice, Mr. Rassp serves as the Chairman of the Board of Directors for Friends Research Institute, which conducts the oversight of human subject medical research under the auspices of the Food and Drug Act. He was appointed as a member of the State Bar Workers' Compensation Law Section Executive Committee in April 1998 and became its Chair in 2000-2001. Mr. Rassp was reappointed as a member of the Workers' Compensation Law Section Executive Committee in May 2003 and is currently an advisor to the Committee. He has conducted workers' compensation judge's training seminars at the request of the California Division of Workers' Compensation, and has conducted over 30 seminars for the workers' compensation community.