Was That Just a Reverse Almaraz/Guzman That Flew By? It is now clear that a departure from a strict application of the AMA Guides is appropriate for cases that do not fit neatly into the diagnostic criteria and descriptions provided for by the Guides. A physician is to use clinical judgment in evaluating impairment even if that means resorting to comparable conditions described in the AMA Guides. Typically, the physician will opine that the strict application of the Guides results in too low of a permanent disability and that a different description within the Guides more accurately reflects applicant's true disability. However, in a case where all of the criteria are arguably met for two distinct impairments, can the QME choose the lower of the two impairments relying on the principles set forth in Almaraz/Guzman II? Read it.

Workers Comp and the Affordable Healthcare Act, by Julius Young, Esq. Assuming that Obamacare isn't grievously wounded by Congressional de-funding and that a Romney win in the election doesn't result in repeal of the law, what effect will it have on workers' comp? I've already received several client e -mails asking whether the Affordable Healthcare Act will have any effect on their cases. Read more.

Understanding the DRE Gap, by Robert G. Rassp, Esq. There is significant confusion in the workers' comp community about whether a spinal injury should fall into a DRE category I, II, or III. Carefully read the instructions in the AMA Guides, Ch. 15, Sec. 15.3, p.383, where the authors distinguish the categories. Consider the DRE gap: Category I assumes that people with a sprained back recover within 6 months to 1 year, justifying a 0% WPI.  But the reality is that there are patients who intermittently have symptoms, such as muscle spasms, muscle guarding, decreased range of motion, etc., and their ADLs are significantly affected for many years. Some physicians try to avoid the DRE gap by assigning a category II in such instances. As long as there is a pathophysiological explanation for the spinal symptoms, the physician may be able to justify a WPI rating. Other physicians use the ROM method to get around the DRE gap by calling a musculoskeletal sprain or strain a "soft-tissue lesion" under AMA Guides, Table 15-7, p. 404, then combining that WPI rating with the ROM rating with no ratable neurological impairments. Source: Lawyer's Guide to the AMA Guides & Calif. Workers' Comp, Ch. 3, § 3.15. Reminder to WCJs: You have access to The Lawyer's Guide on lexis.com.

CAAA Conference Attendees: Take Advantage of 30 Percent Discount Through July 31, 2012. It was a pleasure for LexisNexis reps to meet everyone at the CAAA conference in San Francisco last week! All CAAA conference attendees can still take advantage of our special conference discounts through July 31, 2012. Whether you want print or ebook, LexisNexis has your research solutions, including:

*Hanna, Calif. Law of Employee Injuries & Workers' Comp.

*Herlick, Calif. Workers' Comp. Law (2 vol. treatise)

*Herlick, Calif. Workers' Comp. Handbook (2012 Ed.)

*Calif. WCAB Noteworthy Panel Decisions Reporter

*Lawyer's Guide to AMA Guides & Calif. WC (2012 Ed.)

*Complete Guide to MSP Compliance (2011 Ed.)

*California Compensation Cases (adv. sheets) (annual vol.)

*Occupational Injuries and Illnesses (3 vols.)

To take advantage of this offer, contact Justin Evans asap:

Phone: 1-800-227-9597 ext. 55434

Fax: 1-866-960-3024

Here's a sneak preview of a recent noteworthy panel decision that will be added soon to the LexisNexis services: