Getting Almaraz-Guzman II Ratings Correct

31 August 2012 / Impairment Rating Specialists / Comments Off on Getting Almaraz-Guzman II Ratings Correct

California was the 44th state in America to adopt the AMA Guides for calculating permanent impairment. In fact, this book is the most widely used book in the world for calculating permanent impairment. It is used in all Commonwealth countries, many Federal compensation systems, and in auto accident cases in some states.

Why has this book become the most widely used book for calculating impairment in the world? Because it is based on one simple idea: 2 doctors, looking at the same patient at about the same time and getting the same results, should come up with the same impairment rating. Pretty simple, huh? It says: 2 + 2 should equal 4 each time.

In order to do that, physicians must look at the same things and measure them the same way. These are called objective factors of impairment.

Let me give you an example: If my arm were cut off at the elbow, shouldn't every doctor measuring that be able to measure it the same way and come up with the same result. Yes, and yes. If one doctor said 50% of the arm were cut off, and another said only 10% was cut off, we would say that is wrong, wouldn't we? Yes, and yes.

So, the Guides give doctors things to measure and tell them how to measure them. The goal is for all doctors to be able to calculate impairment the same way by looking at the same body parts and measuring them the same way.

For those of us in California, the concept of two doctors coming up with the same permanent impairment rating is hard to get our minds around because our entire workers' compensation system has been built on two doctors looking at the same patient and coming up with different impairment numbers. Kind of like saying, Dr. A looks at my arm and says 50% is cut off. Dr. B looks at my arm and says only 10% is cut off? Can both of them be correct? No. But, for 50 years in California, instead of saying that one of the doctors was wrong, we would split it in the middle to get the case settled. Kind of crazy, but that is what happened.

California adopted the AMA Guides in 2004 in an effort to end that. The purpose of adopting the Guides was to get correct impairment ratings. Period.

After the Guides were adopted in California, various legal challenges were launched to them in an effort to get rid of them. All of those challenges lost. The Guides were found to be Constitutional, and the Legislature was found to have the power to adopt them to measure impairment ratings.

And, for a period of about 6 months, we began to get impairment ratings which were correct under the Guides. When I say correct, here is what I mean: 2 + 2 = 4. Not 5 or 1,000. It is just like grading a test. If you were asked what 2 + 2 equals and you answered "4," your answer is correct. If you answered "1,000," your answer is wrong. Because 2 + 2 = 4 every time.

And every challenge to the Guides lost, until one: Almaraz-Guzman II.

See tuned for the next blog for the rest of the story.

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