The Schedule for Rating Permanent Disabilities - Part 2

Saturday, February 12, 2005 | 0

The following article by Luis Perez-Cordero, MA, AAPMR, Impairment & Disability Rating Specialist, due to its length, has been broken down in to two parts. The first part provided guidance on what to expect from physicians in their reports in order to be rateable under the new permanent disability rating schedule. This second part of the series will provide guidance on how to actually perform a rating using the new schedule.

LC section 4660's Implementing Tool - 8 CCR section 9805: The Schedule for Rating Permanent Disabilities

The Schedule is to promote consistency, uniformity and objectivity L.C.S. section 4660(d). "Nature of Physical Injury' to be described Using AMA Guides, 5th Edition. Applies to all dates of injuries for which a P&S/MMI report has not been issued by a PTP or QME. P&S/MMI medical reports continue to follow California Code of Regulation Guidelines, principally 8 CCR WCAB section 10606

L.C.S. section 4660(a) - In determining the percentage of permanent disability, account shall be taken of (1) The nature of the physical injury or disfigurement, (2) The occupation of the injured employee, and (3) His/her age at the time of injury, consideration being given to an employee's diminished Future Earning Capacity (FEC).

The evaluating physician consolidates the various impairments for the body part being rated into an AMA Whole Person Impairment rating standard (WPIRS). If rating multiple joints in an extremity, the spine and/or multiple organ systems, physician's does not combine into a WPIRS%, since each extremity joint, spinal segment or body organ system must first be adjusted by the corresponding diminished earning capacity modifier (FEC), Occupation and Age.

To abide with LC section 4664(c)(1)(2), then and only then does the combination values chart tables in Section 8 apply. If an evaluating physician provides you with an AMA Whole Person Impairment Rating Standard for multiple joints of an upper extremity that is not what you rate. If the extremity impairment addresses an impairment to the shoulder, wrist and hand, you must rate each WPIRS% for the individual body parts and then apply the Combined Values Chart on pages 8-1 and 8-2 of The Schedule.

Calculating a Ratings - L.C.S. section 4660(a)(b)(1)(2)
Section 2 Of The Rating Schedule - Impairment Numbers & Earning Capacity Adjustments

Nature of the physical injury or disfigurement shall incorporate descriptions and measurements of physical impairments and their corresponding percentages published in the (AMA) Guides 5th Edition. Employee's diminished future earning capacity (FEC) shall be a numeric formula based on empirical data and findings that aggregate the average percentage of long-term loss of income resulting from each type of injury for similarly situated employees. The AD shall formulate the adjusted rating schedule based on empirical data and findings from the Evaluation of California's Permanent Disability Rating Schedule, Interim Report (December 2003), prepared by the RAND Institute for Civil Justice, and upon data from additional empirical studies.