Recalculation of prior impairment rating required to reconcile injuries

In Nevada, the rating physician must reconcile the different editions of the Guides to the Evaluation of Permanent Impairment by recalculating the previous impairment rating using the current edition and subtracting the recalculated percentage from the current level of impairment.

Case name: Public Agency Compensation Trust v. Blake, No. 54822 (Nev. 11/23/11).

Ruling: The Nevada Supreme Court held that a worker's permanent partial disability award was based on a 17 percent whole person impairment rating.

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What it means: In Nevada, when apportioning permanent partial disability benefits between prior and subsequent injuries when the impairment ratings for the injuries are based on different editions of the American Medical Association Guides to the Evaluation of Permanent Impairment, the rating physician must reconcile the different editions of the Guides by recalculating the previous impairment rating using the current edition and subtracting the recalculated percentage from the current level of impairment.

Summary: A worker injured his back during the course and scope of his employment. He previously suffered four other work-related accidents resulting in back injuries. For his most recent prior injury, he received compensation based on a 14 percent whole person impairment using the second edition of the AMA Guides. At the time of his new injury, the legislature mandated the use of the fifth edition of the AMA Guides. Using that edition, his rating physician found he suffered a 40 percent whole person impairment. The physician determined that his PPD award for the new injury should be calculated using the 26 percent increase in impairment rating. The employer's insurer expressed concern that the impairment rating for the prior evaluation was not comparable to the new evaluation because of the change in editions of the AMA Guides. The physician estimated that the worker's prior level of impairment was 23 percent under the fifth edition of the AMA Guides. The Nevada Supreme Court held that the worker's PPD award should be based on a 17 percent impairment.

The court explained that the calculations for prior and subsequent injuries must be reconciled by first using the current edition of the AMA Guides to determine the percentage of the entire disability and the percentage of the prior disability. The percentage of the prior disability is subtracted from the percentage of the entire disability to calculate the award for the current injury.

Without a recalculation of the prior disability, the two determinations may not be comparable because updates to the AMA Guides can create different percentages of impairment rating for the prior disability. The court said that using a consistent method of accounting for impairment ensures that workers are fairly compensated for their disability.

Read more at the WorkersComp Forum homepage.

January 16, 2012

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