Texas: AMA Guides Must be Utilized in Determining Impairment Rating

Where an injured worker’s medical expert opined that utilizing Advisories 2003–10 and 2003–10b—and not the AMA Guides—the worker, who underwent four surgeries, including a spinal fusion and a laminectomy, had a 20 percent impairment rating, that rating did not comply with Tex. Lab. Code Ann. § 408.124(b) and was invalid. Because the trial court was left with no valid rating, remand was required. The Court also stressed that in considering whether an impairment rating submitted to the Texas Department of Insurance Division of Workers’ Compensation was valid, a reviewing court was not making a determination of impairment. Instead, the court was deciding a purely legal question: whether the proffered rating was made in accordance with statutory requirements. Here the rating had not utilized the AMA Guides and, therefore, the Division could not consider it.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is the co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See American Zurich Ins. Co. v. Samudio, 2017 Tex. App. LEXIS 713 (Jan. 26, 2017)

See generally Larson’s Workers’ Compensation Law, § 80.07.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law