LexisNexis® Legal Newsroom
California: Elements for Rebuttal of a Strict Rating of the AMA Guides

One of the primary goals and foundation of the workers’ compensation system is to provide adequate medical treatment for injured workers, enabling them to promptly return to their usual and customary jobs. Hence, it is not unusual for a worker to be injured, receive appropriate medical treatment...

California: The Cannon Case: Permanent Objective Medical Diagnosis

Throughout the years, since the enactment of SB 899, all of the guidebooks have directed physicians and attorneys to focus on permanent objective medical conditions in order to determine whether that condition is ratable under the AMA Guides . Some people interpret the AMA Guides to stand for the proposition...

Pennsylvania: Psychologist’s Testimony Not Competent to Rebut IRE Evidence Submitted by Employer

A Pennsylvania appellate court held that while a psychologist may provide competent testimony in the claim petition context, if a claimant seeks to rebut competent impairment rating evaluation evidence, he or she must present evidence of similar character—i.e., evidence of rating evaluations performed...

Complex Regional Pain Syndrome as a Central Nervous System Disorder

A case study from California A case handled by this author involved the diagnosis of Complex Regional Pain Syndrome (CRPS) from a lower extremity industrial injury. The WCAB upheld a trial judge’s decision that a WPI rating can exceed the maximum value of an amputation and the medical reporting...

California: Top 25 Noteworthy Panel Decisions (July–December 2014)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period July through December 2014. You’ll find many helpful cases in this list, including a recent decision on reasonable attorney’s fees ,...

California: How Physicians Can Provide the Most Accurate WPI Rating Under the AMA Guides

In Ramirez v. Space Lok, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS 9 (lexis.com), 2015 Cal. Wrk. Comp. P.D. LEXIS 9 (Lexis Advance), the WCAB rescinded the WCJ’s finding that the applicant, a machine operator, incurred 36 percent permanent disability as a result of a 7/23/2012 industrial injury to...

Vermont: Physician’s Use of AMA Guides’ DRE Method—Rather Than ROM Method—for Determining Impairment Did Not Support Reformation of Settlement Agreement

Where settlement in 2002 (via Vermont’s Form 22) of the PPD segment of a workers’ compensation claim was based upon a physician’s use of the AMA Guides’ Diagnosis Related Estimate (“DRE”) and, six years later, two different physicians indicated that it would have been...

Evaluation and Weighing of Medical Opinion Evidence in Longshore Cases

By Yelena Zaslavskaya, Senior Attorney for Longshore, Office of Administrative Law Judges, U.S. Department of Labor, Washington, D.C. This paper highlights some of the considerations relevant to the determination of the probative value and relative evidentiary weight of medical opinions. [fn1] As...

California: Top 25 Noteworthy Panel Decisions (January-June 2015)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period January through June 2015. The list features a number of split-panel decisions, including bonus cases addressing the validity of untimely independent...

California: When to Hold Them and When to Fold Them? Apportionment In Ortho, Psyche, And Internal Cases

This article is a favor to the WCAB commissioners and is a call out to parties and trial judges to develop the record before a case gets to the appellate level. How many times have you been confronted with an “ortho, psyche, and internal” case in which either the psychiatrist or internist...

Vocational Expert Evidence Found Unnecessary to Support PTD Award: Cal. Comp. Cases August Advanced Postings (8/11/2015)

Here’s the latest batch of advanced postings for August 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All rights reserved. G4S Secure Solutions, Inc., National...

California: Top 25 Noteworthy Panel Decisions (July–December 2015)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period July through December 2015. The list features a number of decisions addressing the assignment and reporting of panel qualified medical evaluators...

California: Rating Eye Injuries Using the AMA Guides

One of the most famous and graphically intense workers’ compensation cases of all time is the 1959 case of SCIF v. IAC (Wallin) (1959) 176 Cal.App.2d 10, 1 Cal.Rptr. 73, 24 Cal Comp Cases 302 [ 24 CCC 302 ]. On 2/15/1957, Mr. Wallin, a carpenter, suffered an industrial injury resulting in the total...

Pennsylvania: WCJ’s Rejection of Uncontradicted Medical Evidence Offered by IRE Physician Was Appropriate

Emphasizing that with regard to expert medical testimony, one should not conflate the qualifications of the expert with the persuasiveness of the expert’s testimony, the Supreme Court of Pennsylvania reversed a decision by the state’s Commonwealth Court and held that a WCJ’s rejection...

California: Top 25 Noteworthy Panel Decisions (January-June 2016)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period January through June 2016. The list features a number of decisions addressing utilization review time deadlines and reporting requirements, several...

California Workers’ Comp Case Roundup (7/7/2016)

CALIFORNIA COMPENSATION CASES Vol. 81 No. 6 June 2016 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE © Copyright 2016 LexisNexis. All rights...

Vermont Workers’ Compensation Update: April to June 2016

This list of recent noteworthy cases was compiled by Keith J. Kasper of McCormick, Fitzpatrick, Kasper & Buchard, PC. Argentina Kearney has joined the Department of Labor staff as a Workers’ Compensation Specialist II starting May 16, 2016. Ms. Kearney has most recently been employed...

Illinois: Claimant Need Not Submit AMA Rating Report in Order to Qualify for PD

The Appellate Court of Illinois, Workers’ Compensation Commission Division, held that section 8.1b of the Illinois Workers’ Compensation Act [820 Ill. Comp. Stat. 305/8.1b (2012)], does not require an injured worker to submit an “AMA rating report” for the purpose of determining...

Kentucky: ALJ Appropriately Disregarded Impairment Opinion That Was Not Based Upon AMA Guidelines

It was appropriate for the ALJ to disregard the portion of the injured worker’s medical expert witness testimony that related to visual impairment where the expert, in assessing the overall permanent impairment of the injured worker, based his that assessment on the conclusions of an ophthalmologist...

California: Loss of Function Rating Prevailed Over Strict Anatomic Loss of Motion Rating

A recent case reflects how crucial it is for an evaluating or treating physician to point out all objective medical findings as a result of an industrial injury, and then there has to be a correlation between those objective medical findings and the ultimate WPI impairment rating. In Prell v. Cedar...

Tennessee: Court Awards PTD Benefits for Migraines in Spite of AMA Guides (6th ed.)

The Special Workers’ Compensation Appeals Panel of the Supreme Court of Tennessee affirmed an award of PTD benefits to an X-ray technician who contended her migraine headaches were triggered by exposure to chemicals at a medical clinic where she worked. The panel noted the sharp disagreement in...

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...

AMA Guides Are for Determining Whole Person Impairment, Not Apportionment

The AMA Guides under the California’s workers’ compensation system are for determining whole person impairment (WPI) and not apportionment under Labor Code §§ 4663 and 4664 In two separate cases, Caires v. Sharp Healthcare, 2014 Cal. Wrk. Comp. P.D. LEXIS 145 (WCAB panel decision...

Kentucky: IME May Use Clinical Skill and Judgment in Construing AMA Guides

While a Kentucky physician must base his or her impairment rating regarding an injured worker on the AMA Guides (5th Ed.), the physician is not required to park his or her medical judgment at the examining room door. He or she may utilize clinical skill and judgment in assessing the level of impairment...

Pennsylvania: Court Finds Entire Impairment Rating Evaluation Process Unconstitutional, based upon Protz

The Commonwealth Court of Pennsylvania held that one legal effect of the recent decision of the state’s Supreme Court, in Protz v. Workers' Comp. Appeal Bd. (Derry Area Sch. Dist.) , 161 A.3d 827 (Pa. 2017), was essentially to undermine the legal authority for the entire impairment rating evaluation...