Almaraz­-Guzman II Ratings

04 April 2013 / Impairment Rating Specialists / Comments Off on Almaraz­-Guzman II Ratings

In Almaraz-Guzman II, the WCAB said that there are occasions when a doctor
can use a method of rating something in the Guides which is different from
the rating method specified by the Guides.

Almaraz-Guzman II said that the case must meet the following 4 criteria:

1.  The case must be extraordinary or complex.  (Unfortunately, the WCAB
did not define these terms.)  AND

2.  The evaluating physician must do the specified rating under the Guides   correctly.  AND

3.  The evaluating physician must then indicate that he does not feel that
the specified rating accurately describes the impairment, and he must give
his reasons for this conclusion in writing.  AND

4.  The evaluating physician may then select an alternate method for rating
from the Guides, BUT  (AND HERE IS THE BIG "BUT")  AND

5.  HE MUST DO THAT ALTERNATE RATING CORRECTLY UNDER THE GUIDES
INSTRUCTIONS AND FOLLOW ALL INSTRUCTIONS WHICH THE GUIDES GIVE FOR THAT
RATING.
The WCAB told us that ALL OF THESE CRITERIA MUST BE MET FOR AN
ALMARAZ-GUZMAN II RATING.

Unfortunately, after Almaraz-Guzman II came out, many doctors and lawyers
started to claim that the decision said a doctor could rate "any way he
wanted."  This is absolutely NOT what the decision says.  It says the
physician must follow the criteria of Almaraz-Guzman II for a rating to be
correct under that case.

So, in all of your Almaraz-Guzman II cases, check to ensure that the
criteria above are met.  If they are not, write the doctor (or depose him)
to question him on each of the criteria.

In my experience. 99% of "Almaraz-Guzman II" ratings do not meet the
criteria above.  Simply send the doctor a copy of the decision in
Almaraz-Guzman II and question him on whether or not he complied with each
and every criteria listed in the decision. And, if he did not, then move to
strike that rating as not consistent with Almaraz-Guzman II.

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