News & Publications

Case Bulletin – Pennsylvania Supreme Court to Provide Guidance on Impairment Ratings

On April 15, 2016, the Pennsylvania Supreme Court granted a Petition for Allowance of Appeal in the matter of Protz v. Workers’ Compensation Appeal Board (Derry Area School District)  to determine whether the Commonwealth Court, after finding that the provision of the Workers’ Compensation Act (the Act) pertaining to medical evaluations and impairment ratings was unconstitutional, remanded the case to the Workers’ Compensation Judge with instructions to apply the Fourth Edition of the American Medical Association’s (AMA) Guides to the Evaluation of Permanent Impairment.

 

This matter related to a work injury sustained by the Claimant.  At the appropriate time, the Employer filed a request for designation of a physician to perform an impairment rating evaluation (IRE) under Section 306(a.2) of the Act, following which an IRE physician evaluated Claimant to have a ten-percent impairment rating under the Sixth Edition of the AMA’s Guides to the Evaluation of Permanent Impairment. Because the total impairment rating was less than 50%, the Employer filed a Modification Petition seeking to convert Claimant’s total disability benefits to partial disability benefits, thereby reducing the amount of compensation that can be paid to 500 weeks. The Workers’ Compensation Judge granted the Petition, and Claimant appealed to Commonwealth Court.

 

On appeal, the Claimant challenged the constitutionality of Section 306(a.2) as an unconstitutional delegation of legislative authority pursuant to Article II, Section 1 of the Pennsylvania Constitution because this provision, which requires impairment ratings to be evaluated according to the most recent AMA Guide to the Evaluation of Permanent Impairment,  gives the AMA rather than the General Assembly authority to establish the criteria under which a claimant is adjudicated partially or totally disabled. The Commonwealth Court agreed, finding that the General Assembly has not reviewed or adopted the methodologies of the subsequent editions of the Guides that have been released since Section 306(a.2) was enacted, and that it was an impermissible delegation of authority to a private entity with no accountability to the public. The Court remanded with instructions for the Workers’ Compensation Judge to apply the Fourth Edition of the Guides, which was in effect when Section 306(a.2) was enacted.

 

The Pennsylvania Supreme Court’s ruling is expected to provide guidance on how impairment ratings must be evaluated going forward.