WORKERS COMP – Complex regional pain syndrome, AMA Guidelines: Tokico (USA), Inc. v. Krystal Kelly; Hon. Chris Davis, ALJ; and Workers’ Compensation Board (SC 4/23/2009)

Tokico (USA), Inc. v. Krystal Kelly; Hon. Chris Davis, ALJ; and Workers’ Compensation Board
2008-SC-000480-WC April 23, 2009
Opinion of the Court. All sitting; all concur.

Employer argued on appeal that doctor’s diagnosis of complex regional pain syndrome (CRPS) did not conform to standards of the AMA’s Guides to the Evaluation of Permanent Impairment (the Guides). The Supreme Court held that while diagnostic criteria stated in the Guides have relevance in judging the credibility of a diagnosis, there was no statutory requirement that a diagnosis must conform to the criteria listed in the Guides. The doctor in this case made a diagnosis of CRPS even though the claimant met only 7 of 11 diagnostic criteria —while the Guides require 8 for a diagnosis of CRPS. The Court also rejected the employer’s argument that the ALJ erred by relying on the doctor’s impairment rating for a psychological condition even though the doctor stated the claimant still needed treatment. The Court held that the need for additional treatment does not preclude a finding that the claimant has reached maximum medical improvement.

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