How To Get 100% Permanent Disability In California

• Sep 03, 2023
• Blog
• Michael Burgis & Associates, P.C

Are you arguing for 100% permanent disability in a workers’ comp claim? Click to get all the details of how to maximize your client’s benefit amount.

Michael Burgis of Michael Burgis & Associates, P.C., a certified legal specialist in California Workers’ Compensation, delves deep into the intricacies of arguing for 100% permanent disability in California’s complex worker’s compensation landscape. If you’re seeking clarity on how to secure 100% disability benefits in California for your clients, this video offers invaluable insights.

The core of many disputes lies in the realm of medical apportionment. Defense often argues for it, aiming to reduce the responsibility of the insurance company. A recent case, Vincent Helper vs. County of Sonoma Health Services, has become instrumental in shaping the narrative surrounding this subject. Michael explains how the case distinguishes between medical evidence vs. vocational evidence and how it could aid attorneys in building stronger cases.

One of the pivotal points in achieving a 100% disability claim lies in the work restrictions after an industrial injury. However, achieving 100% disability is not just about medical assessments. Vocational evidence plays a significant role. 

The difference between 99% disability and 100% disability can sometimes span seven figures. And while defense attorneys might look for apportionment to reduce liabilities, it’s essential for applicant attorneys to be adept at countering these moves.

If you’re an attorney facing challenges from insurance companies or if you’re an injured worker navigating the murky waters of worker’s compensation and California Disability benefits, this video will arm you with the knowledge you need to receive benefits. Don’t let insurance companies undercut your claims. For more insights and to understand the nuances of work-related injury lawsuits, subscribe to our channel.

For those advocating for 100% permanent disability benefits or battling work-related injury lawsuits, remember: Michael Burgis & Associates, P.C., are here to assist. If you were injured at work and would like to know the law, contact us for a FREE CONSULTATION (888) 287-4471. We’re here to help, and we bring “Recovery to the injured.”

Transcript:

Are you an attorney and you’re arguing for 100% disability in California worker’s compensation for your client. But the defendant, the insurance company, is disputing the 100% disability and arguing for medical apportionment. There’s a recent case that’s come down that may be helpful to your argument. 

Hi, my name is Michael Burgis. I’m a legal certified specialist in California Workers’ Compensation. I’m a trial attorney and the managing attorney of MB&A.

100% Permanent Disability In California

Often, I argue for 100% disability in cases, and there’s a few ways that you can do this, but one is through medical evidence and then one is through vocational evidence. And very often the defense get confused between valid medical apportionment and valid vocational apportionment. And this case, called Vincent Helper vs County of Sonoma Health Services, helps shed some light on what that burden is. The holding on this case was the applicant was entitled to a 100% permanent disability award when they successfully rebutted the normal permanent disability rating schedule. And here it sounds like there was battling vocational experts, which is very common in my practice.

And very often you’ll see you develop the medical records and that medical record will indicate what their impairment is, their whole person impairment under what’s called the AMA Guides, or when it comes to psychiatric injuries, there’s something called the GAF scale. Now that’s medical apportionment, and apportionment is due causation of disability per the Escobedo decision. So what happens is a doctor will rate the disability and then they’ll address what’s work related, what’s not work related. And very often there’s some apportionment to non-industrial causation. I think in this case it was 15% of the orthopedic was apportioned in non-industrial.

Work Restrictions

So one, as a practice tip for any applicant attorney or injured worker themselves, you want to get all the work restrictions you can across the board from every subspecialty. The greater the work restrictions are, the more likely your vocational expert will opine substantially that you are unable to compete in the labor market. But in this case, there was medical apportionment. I’m guessing the defense vocational expert was therefore relying on that medical apportionment. But again, if the only thing the vocational expert should look at is the work restrictions and they should not be taking AMA guide or medical apportionment into consideration and vocationally, it’s a separate analysis.

And in this case, again, Vincent Helper vs County of Sonoma Health Services.  The defense did not sustain their burden on apportionment. Again, it’s applicant’s burden to show injury AOE/COE, that that injury arose out or was within the course of employment and permanent disability. In this case, they are trying to rebut the rating string by arguing that they are unable to compete in the open labor market based solely on industrial causation.

Apportionment’s Impact on Benefit Amount

And again, the burden shifts to the defense on apportionment, and it’s their burden to show more likely than not based on reasonable medical probability or reasonable vocational probability that there’s valid apportionment. And in this case, defense didn’t sustain their burden. Applicant met their burden, and the applicant was entitled to 100% award.

And I want to press this for the viewers who may not know this. Hopefully, if you’re an applicant attorney, you’re very well aware of this. There’s a catastrophic difference between 99% disability and 100% disability in worker’s comp. And we’re sometimes talking a seven figure difference. So it’s very important. Very important because most defense attorneys, when they are going to concede that somebody is 100% disability, the way they minimize or reduce their liability is to go looking for apportionment, because if they can show that 1% of that, 1% of the inability of can be no labor market, is attributed non-industrial factors. Now, that’s a 99% case, not 100. And they’ve saved their client seven figures.

Legal Help With Disability Benefits and California Workers’ Compensation

If you’re an injured worker or an attorney that’s advocating for somebody you think is 100% disabled and the insurance company is not conceding this. Of course they never will. And they’re arguing for apportionment, give us a call if you have questions. We have the answers. We’re standing by. Also, if you found this video to be informative or helpful, please like, please subscribe below. We put out lots of content that’s really here to help fight these insurance companies in their bad faith, failure to provide benefits and really to help get justice for people who are disabled, especially those who are 100% disabled.