California Appeals Court Upholds Guzman Workers’ Comp Decision

California’s Sixth District Court of Appeal has affirmed the Workers’ Compensation Appeals Board decision in Milpitas Unified School District v. WCAB and Joyce Guzman, allowing physicians to apply any part of the American Medical Association’s Guides to the Evaluation of Permanent Impairment, Fifth Edition (AMA Guides) that most accurately reflects the injured employee’s impairment, instead of being limited to the recommended chapter and rating for an industrial injury designated by the 2005 Schedule for Rating Permanent Disabilities (PDRS). While the PDRS is rebuttable, the decision holds that “it is not permissible to go outside the four corners of the AMA Guides.”

“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 said. “… 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 defense said the decision is likely to increase permanent disability awards.

Yet the Appeals Court said, “The abuses the District and its amici envision are not inevitable outcomes of the WCAB’s decision, however.”

Topics California Workers' Compensation