Court Opinion

ID: 9559907
Source: CourtListenerOpinion
Date Created: 2023-08-21 17:37:47.093439+00
Date Added: 2024-06-11T09:11:50.826420
License: Public Domain

*532COMPTON, Justice,
dissenting.
In this case the court reaches an anomalous result. It acknowledges that Darlene Rydwell is physically unable to return to her pre-injury job; nonetheless, it denies her rehabilitation benefits.
The court argues that this result is not anomalous because Rydwell may be eligible for PTD benefits. At 531. The court notes that an impairment determination is made when the Board “fails to find a permanent total disability.” At 531; see AS 23.30.190(a). Thus, when a doctor consults the American Medical Association Guides to the Evaluation of Permanent Impairment (.AMA Guides) — at the determination of impairment — the possibility of PTD benefits has already been foreclosed; in addressing the issue of “impairment” the Board has necessarily answered the permanent disability question in the negative. Because Rydwell was evaluated for impairment, the court concedes that Rydwell is not eligible for PTD benefits. Thus, under the court’s triple option, At 531 n. 5, Ryd-well falls under category “(3).” Although she is incapacitated to the extent that she cannot return to her previous job, her incapacity “does not warrant” rehabilitation. Regardless of the court’s word games, this is an anomalous and undesirable result.
This case involves considerations of public policy, and interpretation and application of the AMA Guides, all of which implicate Board expertise. Earth Resources Co. v. State, Dep’t of Revenue, 665 P.2d 960, 964 (Alaska 1983); Kelly v. Zamarello, 486 P.2d 906, 916-17 (Alaska 1971). Accordingly, I would defer to the Board’s judgment, which in this case has a reasonable basis.
Alaska Statute 23.30.190 provides in part: “All determinations of the existence and degree of permanent impairment shall be made strictly and solely ... [under the AMA Guides].” AS 23.30.190(b). The only exception is that impairment ratings may not be rounded to the nearest five percent. Id. The legislature thus intended that “permanent impairment” be determined by reference to specific materials that include tables and formulae as well as directions how to apply such data. Section 1.3 of the AMA Guides, entitled “Medical Impairment and Workers’ Compensation,” provides in part:
While medical information is necessary for the decision process, a critical problem arises in the use of that information. Neither in this example nor in general is there a formula under which knowledge of the medical condition may be combined with knowledge of the other factors to calculate the percentage by which the industrial use of the employee’s body is impaired. Accordingly, each commissioner or hearing official must come to a conclusion based on his or her assessment of the available medical and nonmedical information.
It is evident that the Guides does not offer a solution for this problem, nor is it the intention that it do so. Each administrative or legal system that uses permanent impairment as a basis for disability rating needs to define its own process for translating knowledge of a medical condition into an estimate of the degree to which the individual’s capacity to meet personal, social, or occupational demands, or to meet statutory or regulatory requirements, is limited by the impairment. We encourage each system not to make a “one-to-one” translation of impairment to disability, in essence creating a use of the Guides which is not intended.
AMA Guides § 1.3, at 6 (emphasis added). The AMA Guides recognizes the limitations of its rating system; any empirical classification of “permanent impairment,” a condition resulting from multiple variables, will necessarily be imperfect. Accordingly, the AMA Guides contemplates that final decisions regarding impairment be left to a commissioner or hearing official. In this case the Board can best assess the information relevant to the impairment determination.
Both parties concede that even though Rydwell is not “physically impaired” under the AMA Guides, she is impaired in a broader sense; she is unable to return to her previous job. At 527. Certainly the AMA, cautioning against “one-to-one” ap*533plication, contemplated cases in which the application of AMA Guides results does not reflect reality. The narrow construction of “physical impairment” applied by this court is thus inconsistent with the intended use of the AMA Guides.
Furthermore, under the court’s reasoning, “medical stability” assumes an unintended legal significance. Alaska Statute 23.30.041(k) contemplates that an injured worker can enter rehabilitation prior to “medical stability.” It attempts to maintain benefits for workers in rehabilitation who reach medical stability and as a result lose temporary total disability (TTD) benefits. See AS 23.30.185. It maintains income by distributing PPI benefits at the TTD rate. AS 23.30.041(k). From this the court concludes that “eligibility for PPI benefits is a prerequisite for obtaining reemployment benefits.” At 530. However, AS 23.30.041(f)(3) provides: “An employee is not eligible for remployment [sic] benefits if ... at the time of medical stability no permanent impairment is identified or expected.” Id. (emphasis added). Thus, eligibility for PPI benefits only becomes a prerequisite for rehabilitation benefits only after medical stability.
The argument that “medical stability” is the point at which physical impairment should be measured is not supported by law or fact: (1) medical stability is legally linked to the determination of disability1; (2) AS 23.30.190, which defines “permanent impairment,” is not linked to medical stability; and (3) in this case Dr. Smith made a retrospective stability determination.2 It does not appear that the legislature contemplated that rehabilitation benefits be contingent on the date of medical stability.
If the statute does link the physical impairment determination to medical stability, the following question immediately arises: what happens to workers who are undergoing rehabilitation at the time they reach medical stability if they then receive a zero permanent impairment rating? This court’s conclusion would require the Board to terminate their rehabilitation. I cannot see how the legislature intended this result.3 Indeed, this result undermines the intention of predictability that the court ascribes to the legislature. At 531. Employers seeking to avoid paying for rehabilitation may attempt to accelerate the medical stability determination, while workers who cannot return to their pre-injury jobs may attempt to delay.
The Board has the expertise to interpret and apply the necessarily discretionary AMA Guides so as to clarify the relationship between the permanent impairment rating and the date of medical stability, as well as to resolve situations not foreseen by the legislature. Accordingly, we should defer to its judgment.
For all of the foregoing reasons, I dissent.

. The court correctly notes the difference between the disability and impairment determinations. At 531.

. Dr. Smith rated Rydwell zero in September 1990 and at that time set medical stability at August 13, 1990.

.Further issues arise as to whether such workers would have to reimburse the employer for the cost of rehabilitation, and why employers would expend resources to rehabilitate workers, only to have such rehabilitation subject to termination.