N.Y. WC Task Force Seeks Consensus

Mr. Brigham is the founder and president of Brigham and Associates Inc., which describes itself as a "leading [resource] on impairment and disability evaluation."

Mr. Brigham's bio also lists him as the senior contributing editor for the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, and notes that he was a "contributor/author for several chapters, including upper extremities, lower extremities and spine."

In the past, labor groups have cited concerns with instituting the AMA Guides in New York, and the hiring of Mr. Brigham caused some friction between labor and the insurance department.

The AMA Guides are used by several states to assist in the assessment of permanent impairment.

Art Wilcox, a workers' compensation spokesman for the New York AFL-CIO, said that he was opposed to the insurance department's indications that it was looking at bringing AMA-like guides to New York, if not the AMA Guides themselves.

However, Mr. Wilcox said that while he had some concerns regarding Mr. Brigham's association with the AMA Guides, his issue with the hiring of the consultant had to do with the manner in which it was done.

"I don't think the problem was as much [Mr.] Brigham being on [the task force] as that there was no discussion beforehand in the selection of the consultant to the task force," he said.

Noting that there are five parties involved in the task force–the state Senate and Assembly, the governor's office, labor, and the Business Council–Mr. Wilcox said that Mr. Brigham was hired without all of those involved signing off. "We all see ourselves as equal partners on this task force," Mr. Wilcox said.

Regarding Mr. Brigham's work as a consultant, Mr. Wilcox said he did not necessarily doubt the consultant's objectivity. Mr. Wilcox noted that Mr. Brigham was critical of AMA Guides in the past.

Regardless, Mr. Wilcox said Mr. Brigham's work is not going to be used in the ongoing discussions about developing impairment guidelines and that consideration of the AMA Guides is off the table.

Bruce Topman, executive director of the Workers' Compensation Reform Task Force, was less committal regarding the status of the AMA Guides or any other impairment guideline plans. He said, when asked if the AMA Guides are not under consideration anymore, "We have various options that we're going to be addressing. I don't want to get into any specifics one way or another, but there are a whole bunch of options that the working group is going to consider."

Gary Henning, Northeast region assistant vice president for the American Insurance Association, said he did not understand the strong feelings regarding the AMA Guides, but he expressed confidence that those on the task force will hammer out a deal on impairment guidelines.

Mr. Wilcox explained his opposition to the AMA Guides, saying, "AMA has a very systematic device for discounting people who have had previous health problems prior to an injury, so that folks who have some restrictions [prior to injury] don't have the same value as those who don't have a restriction." This does not coincide with the established standard in the state, where "the employer takes you as they find you. If you're good enough to do your job, then you're 100 percent."

David Dickson, past president of the Professional Insurance Agents of New York, observed that New York is a wage-loss state rather than an impairment state. The AMA Guides, he continued, attach certain dollar amounts to certain injuries.

Mr. Wilcox noted that previous New York guides were designed by doctors many years ago. Under New York's previous governor, George Pataki, a group of doctors were brought in to look at those guidelines and update them. However, their work was stopped and he believes such a group should be assembled again to develop "a very New York-specific guideline."

Mr. Topman, the director of the task force, said there have been meetings with the AFL-CIO and there will be more in the future to resolve outstanding issues.