Virginia Court Of Appeals Cites Rassp's "The Lawyer's Guide" As Authority On AMA Guides

An interesting case from Virginia decided in early 2010 illustrates how states are looking for guidance on the AMA Guides and have found authoritative analysis in Robert G. Rassp's The Lawyer's Guide to the AMA Guides and Workers' Compensation (LexisNexis Matthew Bender).

In Fairfax County School Board v. Martin-Elberhi, 55 Va. App. 543, 687 S.E.2d 91 (Va. App. 2010), claimant underwent a total knee replacement in 2005 as a result of a non-industrial medical condition. She subsequently suffered a knee injury at work, which aggravated her pre-existing condition. Without differentiating her preexisting condition from the aggravation, claimant's treating physician rated claimant's impairment at 37%.

The Virginia Workers' Compensation Commission awarded permanent partial loss benefits solely on the basis of the treating physician's opinion. Defendant appealed, contending that the Commission erred as a matter of law because neither the treating physician nor the Commission distinguished between the impairment rating attributable to claimant's 2005 non-industrial total knee replacement and the rating attributable to her 2006 work-related aggravation injury.

The appellate court, agreeing with defendant, reversed the Commission's decision and found that by failing to distinguish between applicant's 2005 knee condition and the subsequent industrial aggravation, the Commission made no holding on the degree of incapacity which would have resulted from the later accident if the earlier disability or injury had not existed, as required by Va. Code Ann. § 65.2-505(A).

Additionally, the court noted that claimant's position that the Commission implicitly found that her impairment rating was wholly caused by the aggravation injury and that her total knee replacement caused no impairment whatsoever, would contradict the Commission's longstanding practice of accepting the American Medical Associations impairment guidelines (AMA Guides) which call for a 37% lower extremity impairment rating attributable solely to a successful total knee replacement (See Robert G. Rassp, Lawyer's Guide to AMA Guides and Cal. Workers' Comp. § 3.17 (2010 ed.). The court remanded this matter to the commission for further fact finding.

Section 3.17 of The Lawyer's Guide to the AMA Guides and California Workers' Compensation is part of Chapter 3 that describes in detail each corresponding chapter of the AMA Guides 5th Edition. Section 3.17 discusses WPI ratings for lower extremity impairments that are fully described in Chapter 17 of the AMA Guides, "The Lower Extremities." Section 3.17 also details how WPI ratings are determined using the 13 methods of evaluating impairments for lower extremity medical conditions that result in anatomic, functional or diagnosis based losses. The Virginia Court of Appeal referred to Section 3.17 that describes how joint replacements for knees and hips are rated for permanent impairment.

To find out how The Lawyer's Guide to the AMA Guides and California Workers' Compensation can help you with AMA Guides cases in your state, click here to order the book from the LexisNexis bookstore.