Tuesday
Jan082019

California Disability Rating Mechanics for Injury Dates on/after 01/01/2013

The California Rating Formula: AMA Guides Impairment-to-California Permanent Disability

Rating Mechanics for Injury Dates on or after 01-01-2013 using The 05PDRS

Below is a Table of the Division of Workers Compensation (DWC) presentations, that address Disability Rating Issues and give examples of how to use the 05PDRS to rate Permanent Disability for dates of injury on/after 01/01/2013.

SB 863 & PD (2013)

Rating Strategies & Senate Bill 863 Issuers (2013)

Rating Strategies for 2014

Addressing Rating Issues – Spine Impairment (2015)

Rating Boot Camp: Upper Extremities (2016)

DEU & Almaraz-Guzman (2016)

Identifying Rating Issues (2017)

Rating Boot Camp: Lower Extremities (2017)

Case Studies in Rating 2018

EnclosureCalifornia Disability Rating Mechanics for Injury Dates on/after 01/01/2013

Monday
Mar162015

Back to Basics 2005 thru 2013: Rating California Case Using the AMA Guides 5th Edition - Uploaded 12-24-2012 

Tuesday
Jan132015

DRE Impairment for Nonverifiable vs. Verifiable Radicular Complaints - Uploaded on 01-13-2015

Before estimating the extent of any impairment, the AMA Guides requires that physicians establish an accurate diagnosis.  The primary requirement is the confirmation of the presence or absence of specific pathology and/or loss of organ function.

Increasingly, we have encountered evaluations providing Cervical and Lumbar DRE II Impairment based on insufficient findings, without reporting any clinical elements (muscle spasm,  guarding, nonverifiable radicular pain) or medical history (prior history of verifiable radiculopathy) in support of the rated impairment. This trend is contrary to Sections 1.5, 15.1b, 15.3, 15.4 and 15.6 guidelines of the AMA Guides 5th Edition.

The attached Spine Impairment Appendix addresses the issue of non-verifiable vs. verifiable radicular complaints.  This Appendix will help you decide if the evaluation you are reviewing meets the minimal requirements for Substantial Medical Evidence in the use of a DRE Category II or a DRE Category III.

Spine Impairment Appendix

Monday
Apr022012

From Packard Thurber to AMA Guides Impairment - August 4, 2004

Understanding the evaluation and determination of permanent disability, it is important for the physician to keep in mind the difference between 'Impairment' and 'Disability.'
Impairment is a medical term. Disability is not.
As David C. Craddock points out, "The concepts of disability and impairment necessarily start with definitions. However, it is important to understand how these concepts relate to real-life situations."
As defined by the AMA Guidelines, Impairment is the loss of use or derangement of any body part, system or function. The definition of disability varies with the purpose and intellectual disciplines of the definers.
California has allowed for ratings for both specific and regional anatomic measurable impairment (objective) factors ratings. But the determination of these impairment ratings has always been incomplete.

Download Full Article (PDF)

Monday
Apr022012

Consistency of AMA Impairment Evaluation & Reporting - Updated June 14, 2012

Chapter 16 Upper Extremity Impairment Evaluation: Upper Extremities Appendix

Chapter 16 Grip Stength Impairment Evaluation: Grip Strength Appendix

Chapter 16 Brachial Plexus/Thoracic Outlet Syndrome Updated:
Brachial Plexus Appendix
 I

Chapter 16  Brachial Plexus, Etiology, Symptoms, Evaluation (Revised):
Brachial Plexus Appendix II

Chapter 16  Brachial Plexus P&S Report Checklist (Revised): 
Brachial Plexus Appendix III

Chapter 15 Checklist for Impairment Evaluation Consistency re: Spine

Chapter 16 Checklist for Impairment Evaluation Consistency re: Upper Extremities

Chapter 16 Neurological Examination & Testing - PND Impairments:
Peripheral Neuropathy (UE PND)

Chapter 16  PND Impairments Medical Report Checklist (Revised 10-07-16):
PND MMI Report Checklist

Chapter 17 Checklist for Impairment Evaluation Consistency re: Lower Extremities