Don’t Believe The Hype: Almaraz/Guzman is the law!

By Jay Shergill Posted on March 9, 2009 Posted in 2005 PDRS, Almaraz / Guzman, AMA Guides, Ogilvie, PDRater, Workers Compensation Resources No Comments Tagged with almaraz, almarez, Binding Precedent, Cal Code Regs, Cal Comp, City Of Long Beach, Comp Cases, Compensation Judges, Compensation Professionals, Decisions, En Banc, guzman, Head In The Sand, Hype, Impairment Rating, Phil Walker, Vocational Experts, Workers Compensation

Guzman II decisions here!

There are numerous workers’ compensation professionals who are incredibly unhappy with Ogilvie and Almaraz/Guzman. Vocational experts are unhappy with Ogilvie, and somewhat hopeful with Almaraz/Guzman. Impairment rating specialists are not happy with Ogilvie or Almaraz/Guzman. These people may be unhappy with these new cases, but at least they’re starting to adapt.

As Julius Young of WorkCompZone.com just reported, some people are dealing with Almaraz/Guzman by putting on “webinars.” Phil Walker and Christopher Brigham have each announced “webinars.” According to Walker’s promotional e-mail, he charges $2,000.00 to appear for a one day seminar – and now he’s giving it away for free.

People will try to convince you that Almaraz/Guzman is not the law or “just” a WCAB decision. Do not believe these people. Ogilvie and Almaraz/Guzman are both en banc cases.

En banc decisions of the Appeals Board are binding precedent on all Appeals Board panels and workers’
compensation judges. (Cal. Code Regs., tit. 8, § 10341; City of Long Beach v. Workers’ Comp. Appeals Bd. (Garcia) (2005) 126 Cal.App.4th 298, 313, fn. 5 [70 Cal.Comp.Cases 109, 120, fn. 5]; Gee v. Workers’ Comp. Appeals Bd. (2002) 96 Cal.App.4th 1418, 1425, fn. 6 [67 Cal.Comp.Cases 236, 239, fn. 6]; see also Gov. Code, § 11425.60(b).)

Ogilvie and Almaraz/Guzman are binding precedent on judges and the WCAB itself. Don’t believe the hype and don’t stick your head in the sand. ((Photo courtesy of blakeimeson)) If you argue it is not the law or not binding precedent, you will lose. Yes, these cases may be appealed and may even be overturned.

I think it likely they will be appealled and highly unlikely they will be overturned.

Ready for testing: Future Life Pension Rate with SAWW/COLA

By Jay Shergill Posted on March 6, 2009 Posted in Almaraz / Guzman, Calculators, COLA, Commutation, Downloads, Free, Life Pension, PDRater, SAWW, Technobabble, Website Updates, Workers Compensation Resources No Comments Tagged with 100%, 100% pd, Benefits Trust, Beta Tester, Cola Adjustment, cola calculation, cola calculator, cola increase, Conventional Wisdom, Cost Of Living, Cost Of Living Adjustment, January 1, life pension calculator, life pension cola, life pension saww, Pension Calculations, Pension Calculator, Permanent Disability, Perspective, ptd, saww adjustment, saww calculation, saww calculator, saww increase, sif, Sjo, subsequent injuries benefit fund, subsequent injuries fund, Wcab, xyzzx, xyzzxsjo, xyzzxsjo2, zyzzyx, zyzzyx road

XYZZXSJO2 - The motion picture! — XYZZXSJO2 - The sequel!

Last week I posted about a recent case from the San Jose WCAB that indicated a life pension SAWW ((SAWW means State Average Weekly Wage)) increase is applied on the first January 1 after the date of injury. You can find a download of the XYZZXSJO2 case here.

I’ve just finished the COLA / SAWW future life pension rate calculator to determine what the future life pension rates are assuming a COLA / SAWW increase of 4.7% per year. If you’re interested in becoming a beta tester for this COLA / SAWW calculator for life pension increases, please drop me a line and ask for access. ((If you have already helped me out as a beta tester, you already have access to this calculator.))

Please keep in mind that this is not a life pension with SAWW / COLA increase commutation calculator. The actuarial math involved in performing that calculation is … intense.

As an interesting side note, this week I saw my very first DEU commutation of a life pension with COLA increase. Unlike the typical commutations everyone receives from the DEU, this commutation calculation was devoid of the actual methodology used. I was pretty disappointed to find this out.

No matter! Help beta test the new calculator by dropping me a line. After you’ve given it a whirl, let me know what you think.

Dave v. EAMS

By Jay Shergill Posted on March 4, 2009 Posted in EAMS, Technobabble, Workers Compensation Resources No Comments Tagged with dave v eams, eams is evil, eams is hal, evil eams, hal, humor, workers compensation humor, youtube video

A few months ago someone e-mailed me this video clip about an attorney struggling with EAMS. My thanks go out to Matthew Brueckner of the Law Office of Matthew Brueckner for putting this together.

XYZZXSJO2 – COLA and SAWW Increase Starts After the Date of Injury

By Jay Shergill Posted on February 25, 2009 Posted in Calculators, Case Law, COLA, Death Benefits, Life Pension, PDRater, Permanent Total Disability, SAWW, Website Updates, Workers Compensation Resources No Comments Tagged with 100%, 100% pd, Benefits Trust, Beta Tester, Cola Adjustment, cola calculation, cola calculator, cola increase, Conventional Wisdom, Cost Of Living, Cost Of Living Adjustment, January 1, life pension calculator, life pension cola, life pension saww, Pension Calculations, Pension Calculator, Permanent Disability, Perspective, ptd, saww adjustment, saww calculation, saww calculator, saww increase, sif, Sjo, subsequent injuries benefit fund, subsequent injuries fund, Wcab, xyzzx, xyzzxsjo, xyzzxsjo2, zyzzyx, zyzzyx road

Last week while Steve was at the Sacramento WCAB he heard about a recent case that held the COLA / SAWW adjustments and increases are calculated based upon the first January 1 following the date of injury. ((COLA = cost of living adjustment.)) ((SAWW = state average weekly wage.))

This case involving SIF (the subsequent injuries fund) is from the San Jose WCAB. The name of the case is “XYZZXSJO2 v. Subsequent Injuries Benefits Trust Fund, ADJ 1510738, SJO 0251902”. The name of the Applicant was anonymized to protect their identity. ((I hope to have a scan of this decision for you soon!)) ((David DePaolo of WorkCompCentral.com has graciously allowed me permission to offer you a copy of XYZZXSJO2 for download! Thanks David!))

Download a copy of XYZZXSJO2 now!

XYZZXSJO2 v. Subsequent Injuries Benefits Trust Fund, ADJ 1510738, SJO 0251902 (With permission from WorkCompCentral.com – go read their site for more info on this case!)

Thus far the conventional wisdom has been that the COLA/SAWW increases are calculated starting with the first January 1 after life pension gets paid out. This is a tremendous change in the COLA/SAWW calculation of life pension.

Assuming a 1/1/2003 injury at exactly 70% permanent partial disability, there would be 426.5 weeks of permanent disability paid after the permanent and stationary date before the life pension gets paid out. This equates to 8.2 years from the permanent and stationary date that has, thus far, not been taken into account with life pension calculations to date. To put this in perspective, if someone had an injury on 1/1/2003 and became P&S on that same date ((Not likely.)) , the traditional method of calculating the life pension with COLA / SAWW increase would be too low by approximately 44%.

At the moment I’m finalizing a COLA / SAWW life pension calculator to determine what the future life pension rates are assuming a COLA / SAWW increase of 4.7% per year. If you’re interested in becoming a beta tester for this COLA / SAWW calculator for life pension increases, please drop me a line and ask for access.

Unfortunately, I don’t have a citation for the 4.7% COLA / SAWW increase, but I believe it to be the offiical average used by the DEU ((Disaiblity Evaluation Unit.)) to calculate commutations of COLA / SAWW increases and adjustments. If you have an official citation or document from the DEU, please drop me a line so I can include that citation here!

MPN’s: Medical Provider Networks

By Jay Shergill Posted on February 23, 2009 Posted in Medical Provider Network, Workers Compensation Resources No Comments Tagged with doctor who, dwc, medical provider network list, mpn, mpn list, tardis

I began maintaining a list of MPN providers about a year ago specifically because I find them so frustrating. ((Photo courtesy of aussiegall)) (Explanation of the photo on the right ((A “doc-in-the-box” is a derragotry phrase for a physician who is, for lack of a better term, in someone’s “pocket.” Doctor Who is a is a British sci-fi television show about someone called “The Doctor” who travels through time in a police box. The photo on the right with the caption is my attempt at humor.)) ) Admittedly, a year ago I was an Applicant’s attorney, but that’s besides the point. Even as a workers’ compensation defense attorney and I’m still frustrated by MPN lists.

In order to find a treating physician with an MPN you need to have a conflagration of events. The right Medical Provider Network link to the right website for the right carrier with the right password.

According to the Division of Workers’ Compensation website, there are 1,334 official and approved Medical Provider Networks for California. Unfortunately, the Division of Workers’ Compensation list of MPN’s is almost completely worthless since it doesn’t include a website link or other useful information about these various Medical Provider Networks. The most useful part about the DWC’s list of MPN’s is that it will tell you whether or not a particular employer/self-insured/insurance company has an MPN. There is a lot of amount of duplication on the official MPN list. I would estimate there are really only about 500 or so unique Medical Provider Networks operating in California.

In any case, I’m maintaining a list of Medical Provider Networks links and passwords. If you know of any additional MPN websites, logins, or passwords, please drop me a line and let me know. Right now, I’m looking for updated links and passwords for:

Concentra MPN (Medical Provider Network)
CorVel MPN (Medical Provider Network)
Keenan & Associates MPN (Medical Provider Network)

Hopefully workers’ compensation professionals on both sides will find this information useful.

Category: Workers Compensation Resources