Pennsylvania Workers’ Compensation Case Provides Thorough Analysis of Impairment Rating Evaluations and Maximum Medical Improvement in Claims Process
Anyone who files a workers’ compensation claim in Pennsylvania will quickly become acquainted with the terms used and the procedures required of the claimant. When an injury occurs, temporary benefits are often quickly granted to assist with the costs of medical care and lost wages. Pennsylvania workers’ compensation laws set limits as to how long one can receive a percentage of the average weekly wage, which is calculated by a set formula. A claimant can file for permanent benefits for continued incapacitation, even prior to the expiration of the temporary benefits.
The Commonwealth Court of Pennsylvania recently reviewed a Workers’ Compensation Appeal Board decision in Neff v. Pennsylvania Game Commission. In this case, the woman suffered an injury through her work of screwing bluebird boxes together, developing carpal tunnel syndrome. She filed a claim for benefits and received temporary compensation for carpal tunnel. The employer then filed a termination petition and suspension to remove itself from the obligation to pay. The injured worker filed a petition to review compensation and medical treatment and received a decision that expanded her work injury to include chronic lateral epicondylitis of the right elbow. She was allowed to keep her temporary benefits, and an agreement was reached regarding the carpal tunnel. All parties agreed that the employer would remain liable for the chronic lateral epicondylitis of the right elbow.
Nearly two years after the agreement, the employer filed a modification petition against the injured worker to change the temporary total disability status to permanent partial impairment. The employer pointed to an independent rating evaluation (IRE), which is a medical examination conducted by approved medical workers, which concluded that the injured worker reached maximum medical improvement and had a whole person impairment rating of 1%. The injured worker responded, and the workers’ compensation judge (WCJ) held a hearing on the issues. The WCJ issued a decision granting the employer’s modification, and the injured woman appealed to the Workers’ Compensation Appeal Board, which affirmed the WCJ decision and then appealed to the Commonwealth Court.
When an injured worker reaches the physical state that is labeled “Maximum medical improvement” (MMI), the worker is considered to be as healthy as he or she could possibly be from the medical and surgical treatment available to him or her. In its decision, the Commonwealth Court pointed out that the possibility of future procedures does not prevent a determination of MMI. The procedures that may occur are generally ones that are not foreseeable in the next 12 months, or have little to no effect on the problematic symptoms. The Commonwealth Court ultimately affirmed the employer’s modification and approved of the WCJ’s reliance on the physician that performed the IRE. The physician performing the IRE heavily referenced the American Medical Association’s “Guides to the Evaluation of Permanent Impairment” when making her determination of a 1% impairment. The Court felt the IRE was conducted within appropriate timelines and provided enough reliance on the AMA Guides to justify the 1% permanent impairment rating.
The road to obtaining the maximum amount of workers’ compensation benefits can be a difficult one. The experienced Pennsylvania workers’ compensation attorneys at Needle Law Firm are here to help you with your claim. Call today at (570) 344-1266.