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

  • January 23, 2020

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.

Full decision here

TGP Analysis

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  • FILED UNDER Catastrophic Impairment
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