Almaraz/Guzman decision to result in work comp increase

By CMTA Staff

Capitol Update, Aug. 20, 2010 Share this on FacebookTweet thisEmail this to a friend

Thursday, August 19th, the Sixth District Court of Appeal released their decision on the Almaraz/Guzman case.  It affirmed the Workers' Compensation Appeals Board's decision in its entirety, which allows deviation from a strict application of the AMA Guides when rating injured workers’ impairment. This decision will result in an increase in workers' comp. costs for California employers.

"We conclude that the language of section 4660 permits reliance on the entire Guides, including the instructions on the use of clinical judgment, in deriving an impairment rating in a particular case," the court noted in its ruling. "The Guides itself recognizes that it cannot anticipate and describe every impairment that may be experienced by injured employees. To accommodate those complex or extraordinary cases, it calls for the physician's exercise of clinical judgment to evaluate the impairment most accurately, even if that is possible only by resorting to comparable conditions described in the Guides. The PDRS has expressly incorporated the entire Guides, thereby allowing impairment in an individual case to be assessed more thoroughly and reliably."  These costs have already been factored into the recent Workers’ Compensation Insurance Rating Bureau recommendation for a rate increase of 29.9%. (See CMTA’s August 13th article:www.cmta.net/legupdate.php)

The decision by the Sixth District Court of Appeal will likely be appealed and taken up to the Californi Supreme Court level.

To see the decision in its entirety, click here:  www.cmta.net/pdf/Almaraz_Ruling_H034853.pdf

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