Legal Question in Workers Comp in California
workers comp
what is ''rate by analogy'' which is the rating by 1 doctor, w/c insurance is not agreeing to this rating.
1 Answer from Attorneys
Re: workers comp
This is a good question and a fairly new concept that knowledgeble doctors are using.
Basically, a doctor must give your "whole person impairment" based on the American Medical Assoc. (AMA) Guides. These guides became effective for injuries after Jan. 1, 2005, and with a few exceptions, some injuries before that date.
The AMA guides are very limiting and studies show that some of the ratings have been reduced to as much as 70%. I have read some research that the reductions range from 50-70% in reduced compensation.
Some doctors have been "rating by analogy" by using different Chapters in the AMA guides or by showing that if you have had "loss of capacity" (i.e. 50% loss of capacity for use of right arm) this could give you a higher rating. They can also refer to the "symptomology" of your injury and "rate by analogy" to a different Chapter
It is a very creative way to come to a more appropriate rating of your impairment.
Of course, the insurance companies will argue against this concept, but I think it has merit and should help your case.
If you have an attorney, he/she may have to fight it out in court, but it is a concept worth fighting for. If you do not have an attorney, you should consult one immediately.
Thank you for your inquiry, if you should have any further questions, you may consult Law Guru or myself.