Category: Workers Compensation Resources

By Posted on Posted in 2005 PDRS, Calculators, Ogilvie, PDRater, Permanent Disability Rating Schedule, Permanent Partial Disability, Technobabble, Workers Compensation Resources No Comments Tagged with , , , , , , , , , , , , , , ,
Could THIS be the elusive Ogilvie formula?
Could THIS be the elusive Ogilvie formula?

So, here’s the deal:  I want to build the absolute most comprehensive suite of calculators and tools for workers’ compensation professionals.  ((Why?  Some people have wacky hobbies.  Maybe you build hockey arenas out of toothpicks.  I build workers’ compensation calculators and give them away for free.  If it will put you at ease, I hope to make money from advertising in the future.))  I also want your help to making them better.

In the last few days several people have sent me questions about the Ogilvie DFEC workers’ compensation calculator: ((Photo courtesy of nerissa’s ring))

  1. Is it possible to get an Ogilvie DFEC adjusted whole person impairment above 100%?
    • I believe it might be theoretically possible to achieve an adjusted whole person impairment above 100% using the Ogilvie DFEC formula.  I could easily include a small variation on the calculation that would prevent it from exceeding 100, but I have not done so because I wanted to replicate the the formulas set forth in Ogilvie as exactly as possible.
  2. Why can’t I use post-injury earnings of $0.00?  What if they have no earnings at all?
    • That’s an extremely valid point.  If you try to use a post-injury earnings of “zero”, it will cause division by “zero” which is not a mathematically legal operation.  Try post-injury earnings of $1.00 or $0.01.  Doing so will give you an answer VERY close to what you need.  ((I know it has a less than friendly error message about this. I’ll see what I can do about fixing that.))
  3. When do you round each calculation when performing the Ogilvie DFEC calculation?
    • The WCAB en banc in Ogilvie rounds to three decimal places at one step and to four decimal places at a second step.  The only way we know what they actually did is by extrapolating from the examples in the decision – they never actually state “round to four significant digits here, round to three significant digits there.”  I have rounded exactly as they did in their examples.
    • At the end of the day, there are two ways to perform the Ogilvie DFEC calculation:  the exact way the WCAB did it (sometimes four, sometimes three decimal places) and the way they probably intended to do it (four decimal places until the end).  I made the judgment call to use the formula as they performed it, warts and all.
    • Why did I choose to round as the WCAB did?  I think it is more defensible to calculate exactly as the Board did, rather than as I think the Board should have calculated.
  4. How do you put the Ogilvie DFEC adjusted whole person impairment into the rating calculator?
    • At this point, you can’t use a different FEC Rank or an Ogilvie DFEC adjustment factor in the 2005 PDRS rating calculator on this site.  In order to accomodate this, I would need to either rewrite the entire calculator or write a new calculator.  One other possibility is that I could modify the Ogilvie DFEC calculation to provide one extra line of information – where it “runs the FEC numbers backwards.”
    • Let’s take this example:  Suppose the body part FEC rank is 1 and whole person impairment is 10.  The normal FEC adjusted whole person impairment would be 11.  Let’s suppose after applying the Ogilvie DFEC formula it turns out you should have an FEC rank of 8 instead.  This would give you an Ogilvie DFEC adjusted whole person impariment of 14%.  I could write a modification of the current Ogilvie DFEC calculator to put 14% into the FEC Rank chart and look up what whole person impairment you would need with an FEC rank of 1 to arrive at 14%.  Would you find this a helpful interim fix?  Please let me know by sending me an e-mail.
  5. Jay, why in the world did the Ogilvie DFEC calculator reference “standard disability”?  Shouldn’t it say “whole person impairment”?
    1. You’re totally correct.  I’ve fixed this.  Mea culpa.

Here’s my request for your help.  In order to make an Ogilvie calculation valid, you need to put in valid post-injury earnings of similarly situated employees.  The WCAB in Ogilvie suggests several possible sources: ((I’ve copied the links directly from Ray Frost‘s Ogilvie spreadsheet/calculator.  Ray has been kind enough to allow me the use of his extensive work restrictions lists.  So, thanks Ray!))

What do you use for post-injury earnings of similarly situated employees?  If I had a better idea where people were looking it is possible that I might be able to automate the inclusion of this informaiton as well.  Please drop me a line and let me know.   If there is a general consensus, I’ll look into the possiblity of having this informaiton automatically imported from an external website.

By Posted on Posted in 2005 PDRS, Almaraz / Guzman, AMA Guides, Workers Compensation Resources No Comments Tagged with , , , , , , , , , , , , , , , , , , ,
AMA Guides 5th Ed.
AMA Guides 5th Ed.

Clearly, Almaraz/Guzman has been a boon to the U.S. Postal Service.  I’ve been receiving Almaraz/Guzman letters from Applicant attorneys on my files ever since the en banc decision came out.  These letters typically fall into one of three categories:

  1. Increased demands for settlement
  2. Demands for additional discovery per Almaraz/Guzman
  3. Letters to the PQME/AME requesting their opinions on impairment outside the AMA Guidelines to the Evaluation of Permanent Impairment, Fifth Edition

I’ve also heard of some doctors completely abandoning the AMA Guidelines to the Evaluation of Permanent Impairment, Fifth Edition, in favor of just analogizing impairment.  This is not what was intended by the en banc panel in WCAB in Almaraz/Guzman.

Here’s what Almaraz/Guzman means for workers’ compensation practitioners:

So, remember:

  1. Whether you agree with the AMA Guides or the 2005 PDRS they’re still the law of the land and must be addressed.
  2. Whether you agree with Almaraz/Guzman, it’s still good law and must be addressed.
  3. Almaraz/Guzman does not absolve a doctor from the responsibility to generate a medical report which addresses the AMA Guides and constitutes substantial medical evidence.

By Posted on Posted in Author, EAMS, Technobabble, Workers Compensation Resources No Comments Tagged with , , , , , , , , , , , , , , ,
Your request for hearing has been DENIED
Request for hearing DENIED

Tuesday I tried to submit settlement documents for a walk-through in Oakland.  ((Photo courtesy of racatumba.)) I had prepared the document cover sheet, minutes of hearing, and had everything ready to go.  As per procedure, I left the packet with the court clerk and came back about half an hour later.

When I returned the settlement documents were still on the counter, but without any indication of which judge I would be seeking approval from.  I was told that the documents had already been signed by the day’s walk-through judge.

That’s when the fun started.

The computer told the clerk that the original documents in front of us had the judge’s signature and that the judge had the file.  The documents clearly did not have the judge’s signature.  However, since EAMS believed the documents were already approved, it felt (?) I  shouldn’t be given the opportunity to walk the documents through.  Even more interestingly, the EAMS was telling us that the documents had been approved that very afternoon.

Since I had stamped the documents in, the clerk did not want to return them to me so that I could ask the judge if he had signed the settlement.  Mind you, the judge would have had to sign the documents (in invisible ink) in the half hour between the time I dropped off the documents and came back to pick them up.  Eventually I was allowed to take the documents with me to ask the judge if he had signed them.

Once before the walk-through judge, I explained that I had no board file because EAMS believed he already had the file and had approved the documents I was handing him.  Puzzled, the judge went to investigate whether he had approved the documents that did not have his signature.  He returned a few minutes later saying that he did not have the file, he did not recall signing the documents, and that he did not recall signing any documents for myself or the Applicant’s attorney involved.  EAMS was adamant that he had signed those documents.

Thankfully everyone in the hearing room was good-natured about the entire thing.  The funniest part about the entire situation is that the court clerk, myself, and the judge were made to doubt our own recollection, the documentary evidence in front of us, and sanity because EAMS said so.

If you haven’t seen this already, you should really see this incredibly funny EAMS video.

By Posted on Posted in Almaraz / Guzman, Author, Business, Calculators, Case Law, COLA, Free, Ogilvie, PDRater, SAWW, Technobabble, Website Updates, Workers Compensation Resources No Comments Tagged with , , , , , , , , , , , , , , , , , , , , ,
Indy 500
Indy 500

Wow!  500 registered users!

Last month I mentioned that this website had a record number of new visitors.  I honestly thought that was an anomalous one day spike in traffic.  Instead we’ve had a sustained increase in new visitors and people signing up to use the workers’ compensation calculators for free.

Since February 13, 2009 ((When the 400th user registered.)) I’ve enjoyed posting about:

Ever since I relaunched this website I’ve had this idea in the back of my mind that getting to 500 users would be a big deal.  There are literally hundreds of workers’ compensation professionals who rely on this website and its calculators to make their lives a little easier.  This certainly feels like a big deal to me.

By Posted on Posted in Almaraz / Guzman, Case Law, Ogilvie, Workers Compensation Resources No Comments Tagged with , , , , , , , , , , , , , , , , , , , , ,
California Court of Appeals, Sixth Appellate District
California Court of Appeals, Sixth Appellate District

Just when you thought things couldn’t get any crazier in workers’ compensation than Ogilvie, Almaraz/Guzman, Benson, and XyzzxSJO2.  Yesterday I found out that on April 7, 2009 the case of Smith v. WCAB (California Youth Authority) is on calendar for oral argument.  As with Almaraz/Guzman, Smith v. WCAB dealt with similar legal issues across two particular workers’ compensation cases.  In case you missed it, here’s the court of appeal decision:

Smith involved an informal denial of medical treatment without a formal petition to terminate medical care under L.C. 4607, after an award of permanent disability. Eight years after Smith’s  award, SCIF refused to authorize epidural injections.  Smith’s attorney sought utilization review, Smith was reexamined by the AME who said the injections were necessary to relieve from the effects of the industrial injury.  Although SCIF then authorized the injections without the need for a hearing, Smith’s attorney sought fees under L.C. 4607.

The WCJ denied Smith’s attorney’s petition for fess since there was no formal petition to terminated medical care.  The WCAB denied reconsideration on the grounds that SCIF’s was not denying all medical treatment.

Amar is substantially similar to Smith, except that in Amar the workers’ compensation judge took the extra step of opining that SCIF’s denial of medical treatment was made in good faith, not unreasonable, and not improper.

However, the 2nd Appellate Court reversed the WCAB in Smith and Amar, stating in relevant part:

“We see no difference when a carrier informally denies some of the treatment that is a necessary part of medical care previously awarded. This is tantamount to a petition to deny medical care even though the carrier continues to provide treatment for some of applicant’s medical care.”

“Insurance carriers who fail to provide previously awarded medical care may not avoid attorney fees to successful applicants’ attorneys through the expedient of an informal denial, even when they do so in good faith.”

I would love to watch the oral argument on this case – but Los Angeles is a bit of a hike for me.  ((I last watched oral argument on the Mt. Diablo Unified School District v. WCAB (Rollick) case back on 8/5/2008.  It was particularly interesting for me since I was familiar with the applicant attorney, defense attorney, and facts of that case.  If nothing else, its always fun to watch judges get snarky.))  I am very very interested to see how this case shakes out.