The Court of Appeal Issued a Published Decision on the Issue of Rebutting a Rating of Permanent Disability Under the AMA Guides

• Posted By: Harvey Brown
• September 1, 2010

This is a very significant case for workers’ compensation principles.

This applicant had an admitted industrial injury.

The applicant saw an Agreed Medical Evaluator (AME) who gave her disability. The AME gave the applicant a loss based upon Activities of Daily Living (ADL).

The case went to trial and was rated. The rater testified the AMA Guides to Permanent Impairment did not permit an AME to compute a Whole Person Impairment (WPI) directly from a ADL loss. The Workers’ Compensation Judge (WCJ) allowed rebuttal of the guides and gave the applicant a higher disability.

On Petition For Reconsideration the Workers’ Compensation Appeals Board (WCAB) indicated the guides are rebuttable, but could not go outside the four corners of the AMA Guides.

The appellate court indicated in order for the physician to go outside the four corners of the guides or deviate from the guides, the physician must explain why and this has to be substantial evidence. There must be a sufficient evidentiary basis to go outside the guides. ==============

Editor: Harvey Brown

Firm: Samuelsen, Gonzalez, Valenzuela and Brown

Address: 18881 Von Karman # 250 Irvine 92612

Phone: 949 252-1300

Case: Milpitas Unified School District v. WCAB (Guzman)
This is a published Court of Appeal case

• Posted In: Disability