LexisNexis has selected some recently issued noteworthy IMR decisions that illustrate the criteria that must be met to obtain authorization for a variety of different medical treatment modalities. LexisNexis...
Oakland, CA -- The California Department of Industrial Relations (DIR) has issued the 2025 assessments that workers’ compensation insurers are required to collect from policyholders to cover the...
Oakland – Alex Swedlow has announced his plans to retire as President of the Oakland-based California Workers' Compensation Institute (CWCI) effective August 2025. Mr. Swedlow’s retirement...
Oakland - A new California Workers’ Compensation Institute (CWCI) analysis that examines how medical inflation impacts allowable fees under the California workers’ compensation Official Medical...
By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board It’s a problem. Petitions for Reconsideration (Recon) are losing their way and delaying their arrival...
Recently, in Eyad v. Airport Commuter, Inc., 2018 Cal. Wrk. Comp. P.D. LEXIS 85 (Appeals Board noteworthy panel decision), a panel of commissioners with the Workers’ Compensation Appeals Board (WCAB) adopted and incorporated a decision by a Workers’ Compensation Administrative Law Judge (WCALJ) addressing the appropriate computation of permanent disability (PD) in a workers’ compensation case. What makes this case so interesting is not that it necessarily stands for a new legal principle concerning the proper calculation of PD, but that the panel upheld the WCALJ’s combining several separate principles in coming up with a significantly higher overall level of permanent disability.
Indeed, what started out in Eyad as a strict American Medical Association (AMA) Guides rating of 58%, after the principles set forth in Milpitas Unified School District v. WCAB (Guzman) (2010) 187 Cal. App. 4th 808, 75 Cal. Comp. Cases 837 and Athens Administrators v. Workers' Comp. Appeals Bd. (Kite) (2013) 78 Cal. Comp. Cases 213 (writ den.) were considered, the final rating turned out to be 98%. 58% would have been worth approximately $88,377.91 while 98% is worth $273,280.98 plus a life pension including cost of living adjustments. To state it plainly, these considerations were worth well over $200,000 to the injured employee.
Cases like Eyad raise the question of whether a PD benefit based solely on a strict AMA Guides rating, without any consideration of the principles set forth in Guzman, Kite as well as Ogilvie v. W.C.A.B. (2011) 197 Cal. App. 4th 1262, 76 Cal. Comp. Cases 624, should constitute an appropriate basis for a PD award any longer. These additional considerations just make too large of a financial difference not to be considered in any given case.
These cases all highlight the fact that the 2005 Permanent Disability Rating Schedule (PDRS) is nothing more than a guide for determining the appropriate level of permanent disability. All of the stakeholders in a workers’ compensation case should take note that it is only once the “strict rating” in accordance with AMA Guides has been established that the true yeoman work of determining an accurate and appropriate level permanent disability actually begins.
Any information or opinions contained in this commentary are not necessarily endorsed by LexisNexis® or its affiliates.
© Copyright 2018 LexisNexis. All rights reserved.
Lexis Advance subscribers who wish to receive a monthly list of noteworthy panel decisions with headnotes should subscribe to California WCAB Noteworthy Panel Decisions Reporter, available in ebook format. The panel decision citations link directly into Lexis Advance.