AI Generated Opinion Summaries

Decision Information

Decision Content

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Facts

  • A worker appealed the Workers’ Compensation Administration's (WCA) order that granted summary judgment to the employer/insurer. The worker's compensation was previously determined based on a temporary total disability (TTD) from an injury, with no permanent partial disability (PPD) awarded. The worker sought to increase his compensation based on a new impairment rating from the latest edition of the American Medical Association Guide (AMA Guide) and an alleged change in physical capacity.

Procedural History

  • Appeal from the Workers’ Compensation Administration, Terry S. Kramer, Workers’ Compensation Judge, July 16, 2013.

Parties' Submissions

  • Worker-Appellant: Argued that despite no change in injury or diagnosis, compensation should be increased due to a new impairment rating in the newest edition of the AMA Guide and an alleged change in physical capacity (paras 2-3).
  • Employer/Insurer-Appellees: Supported the WCA's order and opposed the worker's arguments for increased compensation, emphasizing the absence of a change in the worker's physical condition since the original compensation order (para 4).

Legal Issues

  • Whether the WCA erred by refusing to increase the worker's compensation based on a new impairment rating from the newest edition of the AMA Guide.
  • Whether an alleged change in physical capacity warrants an increase in compensation.

Disposition

  • The Court of Appeals affirmed the WCA’s order denying the worker's claim for increased compensation (para 10).

Reasons

  • The Court, consisting of Judges James J. Wechsler, Michael D. Bustamante, and J. Miles Hanisee, held that:
    The worker's compensation was correctly determined based on the AMA Guide edition applicable at the time the worker reached maximum medical improvement (MMI), and a new edition of the AMA Guide does not constitute a change in physical condition as required for compensation adjustment (paras 6-8).
    A change in physical capacity does not equate to a change in physical condition under the relevant statutes, and the worker admitted his physical condition remained unchanged since the original compensation order (paras 3-4).
    The legal framework and precedents do not support modifying a compensation order based solely on revisions to the AMA Guide without a corresponding change in the worker's physical condition. Such an approach would undermine the finality of compensation orders and conflict with principles of res judicata and law of the case (paras 9-10).
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