Approximately two years ago, we reported on a Board Decision in the matter of Kathy Thomas v. City of Wilmington, IAB Hrg. No. 1417741 (July 30, 2019), where the Board for the first time indicated a preference for the 6th Edition of the AMA Guides over the 5th edition, in the context of total knee replacement surgery.
Specifically, the Board commented: “The Board is well aware that the Claimant’s Bar does not favor the 6th Edition solely for the reason that impairment ratings are lower which in turn translates to a lower financial recovery for claimants. The Board finds that in cases such as this one involving a specific surgical procedure the 6th Edition provides more accurate and equitable ratings that account for favorable surgical outcomes than the 5th Edition. In those cases and cases involving prosthetics use of the 6th Edition would be preferred.” We questioned whether this was the start of a new trend.
Just last week, the Board issued a new Decision in Craig Currington v. City of Wilmington, IAB Hrg. No. 1445651 (Sept. 10, 2021), accepting the opinion of defense expert Dr. Piccioni over that of Dr. Rodgers (same experts used in Thomas). In awarding the lower 6th Edition rating (23%) over the 5th Edition rating (37%), the Board noted that they considered Dr. Piccioni’s experience in performing total knee replacement surgeries over Dr. Rodgers, who does not perform these procedures. Dr. Piccioni testified credibly as to improvements in technology since the 5th Edition was published in 2011 that increase function, including better implants that are designed to match the natural contours of the knee, provide more stability, better materials used, reduced bleeding, and less scar tissue. Mr. Currington had in fact experienced substantial improvement with his knee replacement, as he was limited to light duty before surgery, within months of the surgery was working full duty in a physically demanding job without substantial problems. The Board accepted Dr. Piccioni’s opinion that this great outcome was consistent with the improvements he sees in his own patients due to advancements in technology.