Almaraz/Guzman and Kite: Rebutting the Standard PD Rating

The two doctrines that move California PD ratings off the strict schedule: Almaraz/Guzman (an alternative rating from anywhere within the four corners of the AMA Guides) and Kite (adding impairments instead of CVC-combining them). What each requires, what each cannot do, and how both show up in med-legal reports.

The 2005 schedule makes the AMA Guides rating the starting point — and Lab. Code §4660 makes it presumptively correct, not untouchable. Two doctrines define how far a rating can move and by what road: Almaraz/Guzman governs which number goes in, and Kite governs how multiple numbers combine. Everything else in the pipeline — the ×1.4, the occupational variant, age — runs the same either way.

Almaraz/Guzman — the four-corners rebuttal

In the WCAB’s en banc Almaraz/Guzman decisions, affirmed in Milpitas Unified School District v. WCAB (Guzman) (2010) 187 Cal.App.4th 808, the rule settled here: when the strict, chapter-directed rating does not accurately reflect the impairment, the physician may draw on any part of the AMA Guides — another chapter, another table, the clinical-judgment framework of Chapters 1 and 2 — to express it. The hard limit runs the other way: not outside the four corners of the Guides. An opinion built on non-Guides methods is not substantial evidence, and an A/G alternative without a reasoned explanation of why the strict rating fails is just a bigger number with no legs.

Kite — adding instead of combining

The Combined Values Chart is the schedule’s default: combine largest-first, each addition shrinking. Athens Administrators v. WCAB (Kite) blessed the exception — where the physician substantiates that two impairments compound each other (classically bilateral injuries, where each side’s loss magnifies the other), they may be added. On the engine’s standing example: 18 and 11 combine to 27 on the CVC — added under Kite they make 29, and the gap widens as ratings climb. The arithmetic is trivial — the medicine is the fight, and a Kite opinion that just says “synergy” without explaining it invites rejection.

What this looks like in the file

A careful med-legal report states the strict rating, then the A/G alternative with its reasoning, and flags any Kite addition — which means every disputed case carries two or three candidate ratings. The math side of the dispute is fully computable: rate each version, and the spread between them is the exact dollar value the doctrines are fighting over. The decoder verifies either side’s string against the tables; what it cannot do — by design — is bless the medical reasoning underneath.

One caution cuts both ways: neither doctrine is a magic phrase. A/G fails without a reasoned within-the-Guides analysis; Kite fails without substantiated compounding. The schedule’s rating survives most challenges precisely because rebuttal requires work. Case law summarized for orientation; not legal advice.

Two ratings in every disputed report?

Pro's scenario compare prices the strict rating against the A/G alternative side by side, with court-ready exhibit PDFs — 14-day free trial.

Start free trial

Rate your shoulder right here

Same engine as the tables above — pick your occupation and age, slide the WPI from the report, and carry it into the full calculator when you’re ready.

Loading the engine…

FAQ

What is an Almaraz/Guzman rating?

An alternative impairment rating a physician gives when the strict, chapter-directed AMA rating does not accurately reflect the injured worker's impairment. Under the WCAB's en banc Almaraz/Guzman decisions, affirmed in Milpitas Unified School District v. WCAB (Guzman) (2010) 187 Cal.App.4th 808, the doctor may draw on any chapter, table, or method within the AMA Guides — including the clinical-judgment framework of Chapters 1 and 2 — but must explain why the alternative better describes the impairment.

Can a doctor rate outside the AMA Guides entirely?

No. Guzman's core limit is the "four corners" rule: the alternative rating must come from within the AMA Guides themselves. A rating built on materials or methods outside the Guides is not substantial evidence.

What is the Kite doctrine?

A separate rebuttal, from Athens Administrators v. WCAB (Kite): where a physician substantiates that two impairments compound each other rather than overlapping, they may be added instead of combined on the CVC. Adding always yields more than combining, so the medical explanation — not the arithmetic — is where Kite cases are won or lost.

Does Almaraz/Guzman always increase the rating?

No — it is an accuracy doctrine, not an escalator. Both sides use it: an applicant may argue the strict rating understates the impairment; a defendant may argue an evaluator's A/G opinion is unsupported and the strict rating controls. The scheduled rating remains presumptively correct until rebutted by substantial evidence.

How do A/G and Kite show up in the rating string?

A thorough med-legal report often gives both the strict rating and the A/G alternative; whichever the parties or the judge adopt is what runs through the ×1.4, occupational, and age steps. A Kite opinion changes the last step only: the impairments are added rather than CVC-combined. Rate both versions and the difference is the exact dollar value of the dispute.