G.T. v. The Guarantee Company of North America (18-003334)

The claimant sought a declaration that she was catastrophically impaired as result of the accident due to a 55 percent WPI. The claimant’s assessors opined that the claimant had a 67 percent WPI. The insurer’s assessors opined that she had a 39 percent WPI. Causation and interpretation of the AMA Guides were in dispute. Adjudicator Grieves found, inter alia, that the “California Method” was a suitable method for converting a GAF score into a WPI rating and the claimant’s headaches did not satisfy the test for a WPI rating. The appropriate WPI rating for sleep disorders and disfigurement were also addressed. Adjudicator Grieves concluded that the claimant was catastrophically impaired as result of the accident.