AMA Guides 5 Edition - COA
AMA Guides 5th Edition
Almaraz-Guzman II: The Most Accurate Impairment
Steven D. Feinberg, M.D.
Board Certified, Physical Medicine & Rehabilitation Board Certified, Pain Medicine Adjunct Clinical Professor
Stanford University School of Medicine
Feinberg Medical Group
Functional Restoration Programs Palo Alto, California
stevenfeinberg@
WCAB Conclusions
? A permanent disability rating established by the Schedule is rebuttable
? Burden of rebutting a scheduled PD rating rests with the party disputing it
? Rebutting WPI under the AMA Guides
WCAB Conclusions
? When determining an injured employee's WPI, it is not permissible to go outside the four corners of the AMA Guides
? However, a physician may utilize any chapter, table, or method in the AMA Guides that most accurately reflects the injured employee's impairment
WCAB Caveats
? The WCAB emphasizes that their "decision does not permit a physician to utilize any chapter, table, or method in the AMA Guides simply to achieve a desired result, e.g., a WPI that would result in a permanent disability rating based directly or indirectly on any Schedule in effect prior to 2005"
WCAB Caveats
? The WCAB emphasizes that "A physician's opinion regarding an injured employee's WPI under the Guides must constitute substantial evidence; therefore, the opinion must set forth the facts and reasoning which justify it
? Moreover, a physician's WPI opinion that is not based on the AMA Guides does not constitute substantial evidence
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