The Pennsylvania Supreme Court issued a landmark ruling this summer in the area of workers’ compensation. That ruling has effectively ended the process of forcing injured workers to undergo medical impairment evaluations whose results were governed by a set of American Medical Association guidelines that often produced poor results for workers seeking to qualify for total disability. This major change in the law is just one more example of why, when you’re facing a workers’ compensation issue, you need knowledgeable Pennsylvania workers’ compensation attorneys working on your side who are up-to-date on all of the aspects of the law.
The plaintiff in that Supreme Court case, Mary Ann, worked as a hall monitor for a western Pennsylvania school district. One day, she fell while working and suffered a knee injury as a result of her fall. At first, the employer voluntarily paid her temporary total disability payments. Some time thereafter, the school district had the employee undergo an “impairment-rating evaluation,” a common step in the process. The doctor who examined the monitor gave her an impairment rating of 10%. The doctor, in making that conclusion, relied upon the AMA Guides to the Evaluation of Permanent Impairment, as required by the law.
Since that rating number was below 50%, the school district sought to convert Mary Ann’s status to partially disabled, which would have capped the length of time when she would have received workers’ compensation payments.
Mary Ann took her case to court. She did not argue that the doctor misdiagnosed her impairment level based upon the Guides. Instead, she contended that portion of the workers’ compensation law was unconstitutional. Her case argued to the courts that, by enshrining the Guides into the law as the legal standard for determining levels of impairment, the state Legislature had taken its duty to declare what does (or does not) constitute impairment and impermissibly delegated it to the AMA.
The Supreme Court agreed with the worker. The problem was that, as worded, the law simply gave the AMA too much “unbridled” authority when it came to determining disability. The court pointed out that, hypothetically, under the current law, the AMA could “concoct a formula that yields” almost any variety of results, ranging from a system in which almost no one qualifies as totally disabled to one in which almost everyone does.
The law as written gave the AMA “de facto unfettered control over” a worker’s ability to continue receiving benefit payments after 500 weeks. Some have theorized that the AMA Guides yielded a relatively low number of injured workers with impairment ratings that cleared 50%, meaning a low number who qualified for total disability benefits. That potentially makes this new ruling a “game changer” for thousands of injured Pennsylvania workers, giving them a chance to obtain benefits that better reflect the seriousness of their injuries, instead of the lower impairment ratings and benefits afforded under the system that used the AMA Guides. Insurance experts expect workers’ compensation costs to increase, which would seem to indicate an expectation that the Supreme Court’s ruling will allow more workers to obtain greater benefits through workers’ compensation now.
The skilled Pennsylvania workers’ compensation attorneys at Needle Law Firm are here to help you at every step along the way as you navigate the workers’ compensation system. We have been providing diligent representation and personalized attention for all of our clients for many years.
Contact us today for a free, no-obligation consultation by calling (570) 344-1266.
More blog posts:
Pennsylvania Workers’ Compensation and the “Going and Coming Rule” Exceptions, Pennsylvania Accident Lawyer Blog, Sept. 18, 2017
Pennsylvania Court Affirms Subrogation Rights of Employer Prevent Double Recovery For Injured Worker Receiving Medical Malpractice Proceeds, Pennsylvania Accident Lawyer Blog, Feb. 12, 2016