California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 1 - Division of Workers' Compensation - Qualified Medical Evaluator Regulations › Article 4 - Evaluation Procedures › Section 47 - Method of Evaluation of Immunologic Disability

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For all claims before January 1, 2005,
				  not subject to section
				  47(b), the method
				  of measuring the immunologic elements of disability shall be set forth below in
				  the "Guidelines for Immunologic Testing" as adopted by the Industrial Medical
				  Council on March 17, 1994. The full text of this document id available on the
				  web at no charge at www.dir.ca.gov/IMC/guidelines.html or by calling the
				  Medical Unit at 1-800-794-6900.
(b)
				  For all claims having dates of injury on or after January 1, 2005, and for
				  those compensable claims arising before January 1, 2005, where there has been
				  either no comprehensive medical-legal report or no report by a treating
				  physician indicating the existence of permanent disability, or when the
				  employer is not required to provide the notice required by section
				  4061 to the injured worker, the
				  method of measuring the immunological elements of impairment shall be described
				  in the American Medical Association, Guides to the Evaluation of Permanent
				  Impairment [Fifth Edition] (AMA Guides). Permanent disability shall be
				  described by applying the provisions of the Permanent Disability Rating
				  Schedule adopted by the Administrative Director pursuant to section
				  9805 of Title 8 of the California
				  Code of Regulations.
STATE OF CALIFORNIA
GRAY DAVIS,
							 GOVERNOR
DEPARTMENT OF INDUSTRIAL
							 RELATIONS
Industrial Medical Council
395 Oyster Point Boulevard, 1st Floor, Wing
							 C
ADDRESS REPLY TO:
South San Francisco, CA 94080
P.O. Box 8888
San Francisco, CA
							 94128-8888
Guidelines For Immunologic Testing Adopted March 17,
					 1994
Laboratory testing of immunologic function is appropriate
					 and necessary in the evaluation of industrial injuries but only in selected
					 cases.
Immunologic function testing falls into four general
					 categories:
I. Allergy to a specific
				  chemical agent.
II. Allergy to
				  common antigens from the general and home environment (e.g.,
				  pollens).
III. Malfunction of the
				  immune system unrelated to infection.
IV. Specific infection.
Category I: Allergy To A Specific Chemical Agent
Testing shall be done only when:
A. The worker has been exposed to a specific
				  chemical at work known to cause hypersensitivity.
B. The worker has symptoms or physical
				  findings on examination that can be due to allergy to a chemical
				  agent.
C. The specific suspected
				  chemical agent of interest has been identified.
Testing shall not be done for chemical agents to which the
					 worker has not been exposed.
The purpose of Category I is to confirm that the worker is
					 allergic and reactive to a specific chemical agent. The presence of a
					 laboratory test showing reactivity does not in itself indicate physical
					 disability unless there also are subjective symptoms and/or objective findings
					 of physical impairment which are consistent with such reactivity. Many people
					 have positive reactivity tests but do not have clinical disease. Testing
					 methods must be for the specific chemical agent. They may be blood tests for
					 antibodies, skin tests or special tests such as lymphocyte reactivity to
					 beryllium.
Category II: Tendency To React To Common Allergens
This testing is of very limited use: It is allowable only
					 when the clinical findings (e.g., sneezing, nasal obstruction or wheezing)
					 could be due to either workplace agent or non-industrial exposure. Testing may
					 be of the blood (IgE, RAST) or of the skin (patch, scratch or
					 intradermal).
Category III: Testing Of Function Of The Immune
					 System
In unusual circumstances (e.g., occupational exposures to
					 ionizing radiation or chemotherapeutic agents), direct clinically significant
					 damage to the immune system may occur and be relevant to the assessment of
					 occupationally related disability. Many chemical agents other than
					 chemotherapeutic drugs have been shown to produce subtle effects on the immune
					 system in research studies. However, such subtle effects do not cause
					 work-related disability and cannot be the basis for laboratory
					 testing.
In the unusual circumstance in which the need for immune
					 testing occurs, such testing shall involve some or all the following:
A. Complete blood count
B. Total serum immunoglobulin level and
				  immunoglobulin electrophoresis
C.
				  Total lymphocyte count and counting of T and B lymphocytes, including
				  subsets.