Cal. Code Regs. tit. 8 § 47

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Section 47 - Method of Evaluation of Immunologic Disability

(a) For all claims before January 1, 2005, not subject to section 47(b), the method of measuring the immunologic elements of disability shall be set forth below in the "Guidelines for Immunologic Testing" as adopted by the Industrial Medical Council on March 17, 1994. The full text of this document id available on the web at no charge at www.dir.ca.gov/IMC/guidelines.html or by calling the Medical Unit at 1-800-794-6900.

(b) For all claims having dates of injury on or after January 1, 2005, and for those compensable claims arising before January 1, 2005, where there has been either no comprehensive medical-legal report or no report by a treating physician indicating the existence of permanent disability, or when the employer is not required to provide the notice required by section 4061 to the injured worker, the method of measuring the immunological elements of impairment shall be described in the American Medical Association, Guides to the Evaluation of Permanent Impairment [Fifth Edition] (AMA Guides). Permanent disability shall be described by applying the provisions of the Permanent Disability Rating Schedule adopted by the Administrative Director pursuant to section of Title 89805 of Title 8 of the California Code of Regulations.

STATE OF CALIFORNIA	GRAY DAVIS, GOVERNOR
DEPARTMENT OF INDUSTRIAL RELATIONS
Industrial Medical Council
395 Oyster Point Boulevard, 1st Floor, Wing C	ADDRESS REPLY TO:
South San Francisco, CA 94080
	P.O. Box 8888
	San Francisco, CA 94128-8888

Guidelines For Immunologic Testing Adopted March 17, 1994

Laboratory testing of immunologic function is appropriate and necessary in the evaluation of industrial injuries but only in selected cases.

Immunologic function testing falls into four general categories:

I. Allergy to a specific chemical agent.

II. Allergy to common antigens from the general and home environment (e.g., pollens).

III. Malfunction of the immune system unrelated to infection.

IV. Specific infection.

Category I: Allergy To A Specific Chemical Agent

Testing shall be done only when:

A. The worker has been exposed to a specific chemical at work known to cause hypersensitivity.

B. The worker has symptoms or physical findings on examination that can be due to allergy to a chemical agent.

C. The specific suspected chemical agent of interest has been identified.

Testing shall not be done for chemical agents to which the worker has not been exposed.

The purpose of Category I is to confirm that the worker is allergic and reactive to a specific chemical agent. The presence of a laboratory test showing reactivity does not in itself indicate physical disability unless there also are subjective symptoms and/or objective findings of physical impairment which are consistent with such reactivity. Many people have positive reactivity tests but do not have clinical disease. Testing methods must be for the specific chemical agent. They may be blood tests for antibodies, skin tests or special tests such as lymphocyte reactivity to beryllium.

Category II: Tendency To React To Common Allergens

This testing is of very limited use: It is allowable only when the clinical findings (e.g., sneezing, nasal obstruction or wheezing) could be due to either workplace agent or non-industrial exposure. Testing may be of the blood (IgE, RAST) or of the skin (patch, scratch or intradermal).

Category III: Testing Of Function Of The Immune System

In unusual circumstances (e.g., occupational exposures to ionizing radiation or chemotherapeutic agents), direct clinically significant damage to the immune system may occur and be relevant to the assessment of occupationally related disability. Many chemical agents other than chemotherapeutic drugs have been shown to produce subtle effects on the immune system in research studies. However, such subtle effects do not cause work-related disability and cannot be the basis for laboratory testing.

In the unusual circumstance in which the need for immune testing occurs, such testing shall involve some or all the following:

A. Complete blood count

B. Total serum immunoglobulin level and immunoglobulin electrophoresis

C. Total lymphocyte count and counting of T and B lymphocytes, including subsets.

Cal. Code Regs. Tit. 8, § 47

1. New section filed 5-23-94; operative 6-22-94 (Register 94, No. 21).
2. Amendment of NOTE filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15).
3. Change without regulatory effect amending section filed 7-12-2001 pursuant to section 100, title 1, California Code of Regulations (Register 2001, No. 28). Pursuant to this filing, material adopted pursuant to the Administrative Procedure Act that had previously been incorporated by reference in the California Code of Regulations was instead printed in full in the California Code of Regulations.
4. Amendment filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).

Note: Authority cited: Section 139.2(j)(2), Labor Code. Reference: Sections 139.2(j)(2), 4060, 4061 and 4062, Labor Code.

1. New section filed 5-23-94; operative 6-22-94 (Register 94, No. 21).
2. Amendment of Note filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15).
3. Change without regulatory effect amending section filed 7-12-2001 pursuant to section 100, title 1, California Code of Regulations (Register 2001, No. 28). Pursuant to this filing, material adopted pursuant to the Administrative Procedure Act that had previously been incorporated by reference in the California Code of Regulations was instead printed in full in the California Code of Regulations.
4. Amendment filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).