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Court of Appeal Opinion on Guzman Upholds WCAB Expansive Use of AMA Guides

In an opinion released at the end of August, the Court of Appeal for the Sixth Appellate District, in the case of Milpitas Unified School District vs. WCAB & Joyce Guzman, affirmed the WCAB En Banc opinion.  The Court concluded 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.

Essentially, this does not change the current practice because the Board's decision was En Banc, meaning it was binding on all judges until overturned on appeal.  This first appeal gives solid credence to the reasoning of the WCAB and opens the door to the next level for the defendants: the Supreme Court. Of course, had the decision been the reverse, the outcome would have been the same: further appeal.

It's important to note that multiple additional parties had joined the district in their appeal by filing Amicus Curiae briefs and had essentially argued that the Guides must be used "as written" in order for the Schedule for Rating Permanent Disabilities to promote consistency, uniformity, and objectivity.  The district took the position on appeal that the Schedule is rebuttable, but the criteria set forth in the Guides are not for purposes of making a determination of whole person impairment.  That objective is defeated if impairment ratings could be based on chapters that do not apply to the employee's injury.

While the Court agreed with the district in theory and stated that the Guides should be applied "as intended," the Court further said that one must take into account the instructions on its use, "...which clearly prescribe the exercise of clinical judgment in the impairment evaluation, even beyond the descriptions, tables, and percentages provided for each of the listed conditions."  The Court agreed with the WCAB's expansionist view regarding multiple chapter use where appropriate in the judgment of the physician.  This agreement was in spite of the arguments made by many brief filers and the district that potential abuses could occur.

A copy of the full opinion can be found here.  In the weeks ahead much focus and interpretation of this opinion is certain to come.  One fact remains: This is not the last word on this highly important issue.

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