Table 15-19 being used to justify almaraz-guzman II (Califor

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Table 15-19 being used to justify almaraz-guzman II (Califor

Postby teggem@co.santa-barbara.ca.us on Tue May 31, 2011 8:24 am

Hi everyone: I have an AME that wrote the following, which makes no sense to me:

"Under Almaraz/Guzman, too, [sic], I would refer the parties to figure 15-19. Figure 15-19 provides for a 90 percent WPI for a patient who has lost 100 percent flexion of the lumbar spine. I think this is a much more accurate assessment of this particular applicant's condition who has a failed back."

IMHO, that's ludicrous. a 100 percent loss of flexion of the lumbar spine seems to be covered at Table 15-8 and appears to come out to 11% WPI. So what the heck is he talking about? And what exactly does Table 15-19 mean when it says the maximum whole person impairment for total impairment of the lumbar spine is a 90% WPI?? Is that a typo?

Thanks for any help you can provide. :?
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Re: Table 15-19 being used to justify almaraz-guzman II (Califor

Postby teggem@co.santa-barbara.ca.us on Tue May 31, 2011 9:10 am

Sorry, I meant Figure 15-19.
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Re: Table 15-19 being used to justify almaraz-guzman II (Califor

Postby theAxe on Tue May 31, 2011 9:38 am

See this WorkCompCentral News item from 3/16/11 where WCAB Panel Decision accepted this approach: Izzo's Rebuttal by Analogy Catches Applicants' Attorney's Attention I tried to insert a link but it didn't work :?
Good Luck.
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Re: Table 15-19 being used to justify almaraz-guzman II (Califor

Postby teggem@co.santa-barbara.ca.us on Tue May 31, 2011 1:45 pm

Ugh, that's not good. I wonder if the defendant filed a writ with the Court of Appeal? I don't get how complete impairment of the lumbar spine could be 90% WPI anyway. And also, the doctor in my case is just wrong about complete loss of FLEXION of the lumbar spine being a 90% WPI. Complete loss of flexion and complete impairment are two totally different things. So maybe that is what I have to hang my hat on.
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Re: Table 15-19 being used to justify almaraz-guzman II (Califor

Postby denyse on Fri Jun 03, 2011 8:45 am

See the Legal forum. 15-19 is an issue discussed.
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Re: Table 15-19 being used to justify almaraz-guzman II (Califor

Postby denyse on Fri Jun 03, 2011 8:51 am

It's SCIF, so let hope they don't screw it up.
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Re: Table 15-19 being used to justify almaraz-guzman II (Califor

Postby TC on Wed Jun 08, 2011 5:25 pm

AAs cite Laury v. R W Concrete Contractors 2011 Cal. Wrk. Comp. P.D. LEXIS 77, and DAs cite Wood v. U-Haul 2010 Cal. Wrk. Comp. P.D. LEXIS 535. Both cases re whether figure 15-19 may be used in an Almaraz/Guzman II rebuttal, but the cases concluded with conflicting results. You choose which is correct.

The Appeals Board in Wood noted that Figure 15-19 on page 427 of the AMA Guides is not intended to determine PD. Rather, it is a conversion table used to convert WPI to regional spine disability. The Appeals Board in Wood also found the medical report was not substantial evidence.

See AMA Guides Newsletter, January/February 2011, page 14.
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AMA Guides Newsletter(Jan Feb 2011) re Fig 15-19.pdf
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