The Proposed PDRS - Defense Perspective

Sunday, December 19, 2004 | 0

The new Permanent Disability Rating Schedule (PDRS) proposed by the Administrative Director has stirred up considerable debate and conversation in the California workers' compensation community. To highlight the debate on the topic, WorkCompCentral presents two opposing views. The following is a view of the new, proposed, PDRS from the defense perspective. In the Attorney segment the opposing viewpoint is debated.

By Luis Perez-Cordero, MA, AAPMR,
Impairment & Disability Rating Specialist

On December 07, 2004 The California Applicant's Attorneys Association (CAAA) gave a press conference in Sacramento, California. They presented a scientific study they have commissioned from the Department of Public Health Sciences, University of California, Davis entitled Estimates Of Differences In Workers' Compensation Disability Ratings Under Current (2004) Law And Impairment Ratings Under Future (2005) Law In California. J. Paul Leigh, Ph.D., and Stephen A. McCurdy, M.D., M.P.H prepared the report.

* Look beyond the well-controlled sample-base and the understandable segmental analysis of permanent disability and take note of the un-intended result. It is not unwelcome to have such support for the Administrative Director's (AD), Andrea Hoch, proposed changes to the Schedule for Rating Permanent Disabilities as mandated by SB 899. Does the study truly support a 2/3rd decrease of benefits? Or does it reveal the inflation in the average compensation of greater than 65%?

On the whole this study provides us with enlightening support of what has happened to Permanent Disability in the State of California -- when it is no longer attached to its origin of anatomic and clinical impairment. Without this foundation, The Rating Schedule turns into a 'menu' of flawed analogies for 'legal' work restrictions that only derive authority from a 'formal' statute or law without any basis in fact.

We now have a scientific study that contrasts rating word-definitions of disability with a pre-determined assigned value, and rating disability as was originally intended by the Schedule: a loss of use or derangement of any body part, organ system or organ function which affects an individual ability to compete taking into consideration the age and occupation of the injured employee on the date of injury.

The study's methodology emphasized the use of reports by Agreed Medical Examiners (AMEs), which were reviewed by a team of 15 physicians with either QME or AME status. The evaluating physicians' 'rated and combined' multiple segments of the spine, joints in an extremity or multiple body parts/organ systems into one WPIR% as espoused by The 5th Edition of the AMA Guides.

When asked specifically if the reports were "rated out," Dr. Leigh said "No." In other words, the reports were not subjected to the proposed methodology that produces a final permanent disability rating for purposes of an indemnity calculation: modifications for (1) Diminished earning Capacity (DEC), (2) Occupation and (3) Age. (The 2005 Schedule Draft was not yet available.)

In an e-mail communiqu