Highlights of Noteworthy Decisions

Decision 208 13
22/02/2013
B. Goldberg - S. Sahay - A. Grande
  • Psychotraumatic disability
  • Permanent impairment {NEL} (degree of impairment) (shoulder)
  • Permanent impairment {NEL} (rating schedule) (AMA Guides) (rating not recognizing severity of impairment)

The worker suffered bilateral shoulder injuries in an 18-foot fall in 1997, for which he was granted a 21% NEL award, later increased to 27% and then to 28%. The worker appealed a decision of the Appeals Resolution Officer denying a discretionary increase in the NEL award and denying entitlement for psychotraumatic disability.

The AMA Guides state that, in rare cases, the severity of the clinical findings, such as loss of shoulder motion, does not correspond to the true extent of the musculoskeletal defect as demonstrated by imaging techniques. If the examiner feels that the measured anatomical impairment does not appropriately rate the severity of the condition, an additional impairment can be given at discretion.
There was no evidence of significance in this case to demonstrate that this provision in the AMA Guides applies to the worker's situation. In particular, there was no evidence of significance that the clinical findings on range of motion do not reflect the worker's impairment or the severity of his injury. The worker was not entitled to a discretionary increase in the NEL award for shoulder impairment.
On the evidence, the worker had entitlement for psychotraumatic disability.
The appeal was allowed in part.