This post has been rated "R" for some rating and mild humor
We’ve all seen ratings from various sources – the DEU, opposing counsel, clients, and professional raters. 1 My question to all of you dear readers is – what do you like to see in a professional permanent disability rating?
As I mentioned previously, each of these cases is about 50 pages long, so there is clearly no substitute for reading them for yourself. However, here’s Ogilvie II and Almaraz/Guzman II in five sentences:1
The WCAB appears to have created a right to reopen a case for “individualized proportional earnings loss.”
Vocational testimony is not an appropriate way to dispute the DFEC portion of the 2005 Permanent Disability Rating Schedule.
(Bonus Dissent Summary: The lone dissent by Caplane says that vocational testimony should be considered proper rebuttal to an entire permanent disability rating.)
Almaraz/Guzman II:
The WCAB ruled that a doctor must issue reports within the “four corners” of the AMA Guides 5th Edition to comply with Labor Code Section 4660(c). 2
However, either party may obtain rebuttal evidence in the form of supplemental reports and depositions regarding the use of any other chapter, method, or table within the AMA Guides.
(Bonus Dissent Summary: The dissenting opinion from Brass, Caplane, and Moresi says they would affirm their decision in Almaraz/Guzman I.)
What do these cases mean for the practitioner?
The WCAB has created a new right to reopen for a higher than expected “individualized proportional earnings loss.”
Here, the phrase “four corners of the AMA Guides” just means the parties are restricted to the actual text of the AMA Guides and cannot use analogies and evidence from outside the AMA Guides. [↩]
It turns out that this website is actually in the top 5% of all blogs in the WORLD. Where did I get this incredible statistic? The Internets, of course.1
Unfortunately, one of the coolest features of my calculators is that some of them will give you the answer you’re looking for before you’ve even finished typing the search term. This works with the:
While these are all very cool while you’re sitting at your computer, I found out (much to my dismay) that this system didn’t work at all when using these online calculators from my cell phone! 1 Well, I’ve updated the calculators to make them more compatible with more phones.2
Save yourself from your own workers’ compensation claim and just leave that heavy rating manual at home.
It has to do with cross-browser compatibility and inconsistent support for javascript events. I doubt anyone is interested in this. [↩]
Permanent disability calculators that will fit in any pocket!
I was at the San Jose WCAB on Friday. Since recently discovering that I could run this website’s permanent disability rating calculators from my phone’s web browser, this was the first time I left my rating manual, money chart, and date wheel in the car.1
It was great. That morning I used my phone to:
Find the ADJ number associated with the legacy SJO number on my file
The benefit for me is not so much that I don’t have to carry the rating manuals, dollar value charts, and date wheels. Unlike these tools, my phone is not something I’m going to misplace or loan and never see again.
The best part is that if I want to refer back to the calculation I just performed, I can just e-mail it to myself!
I was recently sent feedback about the Ogilvie DFEC rebuttal calculator on this website. 1 Here’s how I’ve incorporated that feedback:
Inputs. The calculator results repeats the inputs with the results. This ensures that the answer provided gives you enough context when showing the calculation to the other side or when you go back to review your file.
Links. I’ve added a link to the various Employment Development Department and U.S. Dept of Labor, Bureau of Labor Statistics inside the calculator itself. It doesn’t automatically obtain the information, but hopefully you will find this helpful.
There are two other issues I’m thinking about:
An easy way to pull up the FEC rank of a particular body part. Its kind of a pain to look up the body part, find the FEC rank, and then enter that into the calculator. I’m thinking ways to simplify this process. This shouldn’t be too bad to write.
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. 2
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.
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. 12
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. 34
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 date5 , 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 DEU6 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!
I have no intention of manufacturing FEC Ranks 9 through 20 for the following reasons:
Maintaining Standards. The entire point of a rating schedule is to allow a standardized method for calculating disability and expressing those disability calculations. If I invented my own FEC Rank system beyond the scheduled 1-8 Ranks, I would essentially be creating my own rating calculation system. I’ve gone to considerable lengths to ensure that the rating strings produced by these permanent disability calculators are as standardized, recognizeable, and universal as possible.
FEC Ranks are Irrelevant. The FEC Rank system is a simplified method of applying DFEC adjustment factors. When you use the FEC Rank of a particular body part to adjust the standard using the charts on pages 2-6 and 2-7 of the 2005 PDRS (permanent disability rating schedule), what you’re really doing is essentially multiplying your standard disability against the FEC adjustment factor associated with the particular FEC Rank for the body part in question. An FEC Rank is only useful for telling you the appropriate FEC adjustment factor to apply to the standard disability. Thus, FEC Ranks are irrelevant and FEC adjustment factors are all important.
Arbitrary FEC Ranks. FEC Rank 1 has an FEC adjustment factor of “1.100”. However, using the OgilvieDFEC rebuttal formula, it is possible to end up with very low FEC adjustment factors. In extreme circumstances it would be possible to have a negative FEC adjustment factor. The only way to resolve this would be to have several possible negative FEC Ranks. Besides being somewhat silly, worrying about additional FEC Ranks2 misses the point. If you’re using the OgilvieDFEC rebuttal formula properly, the result will be a new FEC adjustment factor. If you already have the FEC adjustment factor, you have no need for the FEC Rank!
When I had discussed the impact of Ogilvie earlier, I had pointed out that in some cases the resulting formula will dictate that you use a different FEC Rank than the one indicated by the affected body part. In other cases you will need to use an entirely new FEC adjustment factor. In order to keep the 2005 disability calculator current I will eventually have to create a way for the user to override a body part’s standard FEC Rank and specify a new FEC Rank or their own FEC adjustment factor.
I’m not in any particular rush to develop this feature since Ogilvie seems to require three years of post-injury earnings. I doubt we’re going to see litigation begin in earnest over Ogilvie issues for another 18 to 24 months.
A few weeks ago I posted about the Multiple Disabilities Table for combining disabilities with injuries prior to 2005.
For injuries after 2005 we must turn to the 2005 Permanent Disability Rating Schedule. When combining disabilities for injuries after 2005 there are several possible alternatives. You can: