Workers Comp Zone


Some of you have been twiddling your thumbs for the last several years waiting for a titanic appellate court battle between conflicting appellate districts on the Almaraz-Guzman doctrine.

Stakeholder groups made a pretty penny sponsoring seminars on the impending battle.

Charlatans came out of the woodwork, barnstorming the state with their seminars and tutorials.

Early on many of you expected that one court might uphold the Almaraz-Guzman en banc doctrine and that another would not. You fantasized the issue landing on the doorstep of the California Supreme Court.

But it never worked out that way.

The 6th District Court of Appeals upheld the doctrine of the WCAB as set forth in the Almaraz-Guzman II en banc decision.

Then the California Supreme Court refused to hear the Guzman case.

And like balloon boy’s collapsing dirigible, the whole impending appellate court battle deflated today.

The 5th District Court of Appeals dismissed the petition for writ of review in Almaraz.

From a practical standpoint, Almaraz-Guzman is the law.

How much the doctrine actually benefits claimants and how much extra cost it adds to the system aren’t clear now. I suspect the effect is no where near the blockbuster effect predicted by some in the insurance industry several years ago.

We’ve already had many post Almaraz-Guzman panel decisions. In those decisions the WCAB is sorting through what will pass muster, and what won’t.

Frankly, there are many, many panel decisions where the Almaraz-Guzman effort by the doctor failed to make the grade. In many of those the doctor failed to master the proper Almaraz-Guzman standard or failed to explain the how and why in order to justify the rebuttal of the generic AMA rating.

What is clear is that the AMA Guides, 5th edition is a complicated document. It’s not as simple to assign cookie cutter ratings using the book as some of the self-serving experts claimed.

Chalk this battle as one that workers won.

Here is a link to the Almaraz and Guzman II en banc decisions: … ep2009.pdf

Stay tuned.

Julius Young

Category: Understanding the CA WC system