Alaraz/Guzman II Ratings and AMA Guides

20 March 2012 / Impairment Rating Specialists / Comments Off on Alaraz/Guzman II Ratings and AMA Guides


I take hundreds of doctor depositions under the AMA Guides across California.

And here is one thing I can share with you:  most doctors believe that Almaraz/Guzman II says they can simply ignore the AMA Guides.


In Almaraz/Guzman II, the WCAB said there are 4 criteria which must be met for use of Almaraz/Guzman II for a rating:

First, the doctor must do the rating specified by the Guides for the diagnosed condition correctly, following all instructions in the Guides that go with that rating.  (In 90% of the cases, doctors do not do this.)

Second, the physician must then state that the specified rating in the Guides (which he has done correctly) does not adequately describe the Applicant's impairment.

Third, the physician must indicate the case is extraordinary or complex.  (Many do not do this and use Almaraz/Guzman II in every case.  Wrong.)

And fourth, and most important, the doctor must select another rating in the Guides, perform that rating correctly, and follow all instructions in the Guides relating to when and how that rating is to be done.  

(This is the area where doctors simply try to pick and choose parts of a rating they like and ignore the rest.  In Almaraz/Guzman II, the WCAB specifically said that the Guides are an integrated document and that the doctor must follow the instructions relating to the rating.)

So, don't let doctors tell you that they can simply do the rating anyway they want under Almaraz/Guzman II. This is not accurate.  When they ignore provisions of the Guides, file a Motion to Strike the report as not consistent with the AMA Guides and Almaraz/Guzman II.  

Or, better yet, use a doctor who does the rating correctly.  You can find them at Impairment Rating Specialists or through my Doctor Accuracy List which you can get for free by emailing

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