Opinion ID: 1131510
Heading Depth: 1
Heading Rank: 1

Heading: Employer's evidence.

Text: Our standard of review in workers' compensation cases is to determine whether the order of the compensation court is supported by any competent evidence. Parks v. Norman Municipal Hospital, 684 P.2d 548 (Okla. 1984). The first issue involves the opinion of the employer's doctor and his assertion that his opinion deviated from the Guides. The relevant [1] statute states in part: Except as otherwise provided herein, any examining physician shall only evaluate impairment in accordance with the latest `Guides to the Evaluation of Permanent Impairment' adopted and published by the American Medical Association. The examining physician shall not deviate from said guides except as may be specifically provided for in the guides. These officially adopted guides shall be the exclusive basis for testimony and conclusions with regard to permanent impairment with the exception of paragraph 3 of Section 22 of this title, relating to scheduled member injury or loss; and impairment, including pain or loss of strength, may be awarded with respect to those injuries or areas of the body not specifically covered by said guides. 85 O.S.Supp. 1986, § 3(11). (Emphasis added). This statute states plainly that a physician must evaluate impairment according to the Guides [2] An impairment rating may deviate from the Guides if the exception is specifically provided for in the guides. In other words, to deviate from the Guides such deviation must be allowed by the Guides itself. [3] We must initially determine which edition of the Guides applies. The examining physician must use the latest edition of the Guides. 85 O.S.Supp. 1987, § 3(11). [4] The first printing of the third edition of the Guides was in November of 1988. The claimant's examinations by the employer's doctor occurred in November of 1987 and February of 1988. Clearly, the second edition was the appropriate standard by which to determine York's impairment. A review of the findings made by the employer's doctor is needed in discussing the doctor's deviation from the Guides. The employer's doctor, Dr. F., referred York to a hospital where he received spirometry tests in October of 1987. The tests indicated a severe obstructive and restrictive lung disease. In the first examination York's forced vital capacity (FVC) was 44% of the predicted value, and this indicates a severe impairment. [5] Dr. F. reported, however, that York appeared, walked, and acted vigorously and was of the opinion that York had no lung disease. He said, In this respect, of course, I am taking exception to the AMA Guides, as I feel the Guides do not take into consideration hyperventilation syndromes and anxiety as causing false results on the pulmonary testing procedures. This man's hyperventilation syndrome is not related to any job circumstance. Dr. F. requested further spirometry tests and an analysis of arterial blood gases. The spirometry tests were repeated in February of 1988. On the same day York's FVC was first 42% and then 82% of the predicted normal value, and his FEV1 was first 53% and then 83% of the predicted normal value. York's highest values for FVC and FEV1, 3.37 and 2.87 respectively, show a mild impairment i.e., a Class 2 impairment. [6] Dr. F. reported: Finally, I will repeat my original statement as of my report of November 11, 1987 that this man has no lung disease and he has had no lung disease. His only problem is hyperventilation syndrome. In other words, when the pulmonary studies are not reliable and not performed properly with inconsistent results, it is my opinion that these results cannot be used at all and one must evaluate these people on the basis of their clinical status and objective findings which cannot be changed. Again, due to the above reasons I again will take exception to the AMA Guides and rate this man as having zero impairment due to his lungs. This man is perfectly healthy and can continue doing his usual type of work without restrictions. This report indicates that the spirometry test results cannot be used to determine impairment because they are inconsistent with each other. We first address the inconsistent results and then the rating of no impairment.