In California Workers’ Compensation Law, Medical Evaluators are asked to report and determine an Injured Workers’ Permanent Disability. In California, Permanent Disability is generated by the Medical Evaluator’s reporting. The Evaluator’s reporting assesses the Injured Worker’s Permanent Disability in the form of a Whole Person Impairment (WPI.) Whole Person Impairment is generated by using the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th Edition (AMA Guides.)
Sometimes, Injured Workers are assigned a zero percent whole person impairment by an Evaluator for their permanent disability. A zero percent whole person impairment has significant implications for an Injured Worker. This article will discuss (a) the meaning of “whole person impairment,” (b) what a “zero” whole person impairment means? and (c) what “zero” percent whole person impairment impacts other benefits?
What Is Whole Person Impairment (WPI)?
American Medical Association Guides to the Evaluation of Permanent Impairment, 5th Edition, on Page 603, defines “Whole Person Impairment” as the “percentages that estimate the impact of the impairment on the individual’s overall ability to perform activities of daily living, excluding work.”
How Does the AMA Guides Defines Zero Percent Disability?
In the AMA Guides, “[a] 0% whole person (WP) impairment rating is assigned to an individual with an impairment if the impairment has no significant organ or body system functional consequences and does not limit the performance of the common activities of daily living indicated in Table 1-2.” [emphasis added.]
What Are The Activities of Daily Living( ADLs) that are to be addressed?
Table 1-2 of the AMA Guides provides a list of Activities of Daily Living.
Table 1-2, defines “Activities of Daily Living Commonly Measured in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) Scales” These ADLs include:
“Self-care Urinating, defecating, brushing teeth,
personal hygiene combing hair, bathing, dressing, oneself, eating.” [emphasis added.]
“Communication Writing, typing, seeing, hearing, speaking” [emphasis added.]
“Physical activity Standing, sitting, reclining, walking, climbing stairs” [emphasis added.]
“Sensory function Hearing, seeing, tactile feeling, tasting, smelling” [emphasis added.]
“Nonspecialized Grasping, lifting, tactile hand activities discrimination” [emphasis added.]
“Travel Riding, driving, flying” [emphasis added.]
“Sexual function Orgasm, ejaculation, lubrication, erection” [emphasis added.]
“Sleep Restful, nocturnal sleep pattern” [emphasis added.]
What Should Happen in Your Evaluation to Address ADLs?
To properly assess the Industrial Injury’s impact on ADLs, the Evaluator should interview the Injured Worker about their ADLs, they should have the Injured Worker address them via filling out an inventory of their ADLs and their difficulties concerning them. Also, the Evaluator should look to their examination, any testing done, and their review of records to further give them insight as to the injury’s impact on ADLs.
How Can a Zero WPI Be Wrong?
It is this author’s contention that if the Evaluation Reporting shows that there is “limited performance of the common activities of daily living” then, per the AMA Guides, by their definition, it cannot be a Zero Impairment. Therefore, the report should be questioned. This can be done by deposition of the Evaluator, interrogatory of the Evaluator, or the offering of another Evaluator with differing opinion.
How Does a Zero Percent WPI Impact the Eligibility to Obtain a Job Displacement Voucher?
Labor Code Section 4658.7, provides that for injuries on or after 1/1/13, a requirement for obtain a job displacement voucher is that the injury caused a permanent partial disability. A “zero” percent whole person impairment assessment will, in most circumstances, will yield a zero percent permanent disability. A zero percent disability will bar the Injured Worker from obtaining a voucher.
As an Injured Worker With a Zero WPI Report, What Should I Do?
You need to reach out a Practitioner within Workers’ Compensation to evaluate the report to see what can be done. Don’t be discouraged by the Medical Evaluators report. Seek advice to see if there are problems with the report and if there is a strategy to correct the problem so that you can obtain a “fair and accurate” assessment of your impairment. There is caselaw to support this. See Almaraz Guzman vs. Environmental Recovery Service (2009) 74 C.C.C. 1084.
What If I Need Advice?
If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.