• PA Ruling on the Impairment Evaluation Process
  • August 7, 2017
  • Last month, the Pennsylvania Supreme Court ruled that the state’s current impairment rating process used to gauge injuries for Workers’ Compensation claims is unconstitutional. The ruling came after a worker who suffered a knee injury in 2007 appealed the original evaluation of her claim. After receiving temporary total disability benefits for four years, she received a second impairment rating evaluation. In this evaluation, she received an impairment rating of 10 percent, a rating made according to the American Medical Association’s Guides to the Evaluation of Permanent Impairment. The worker’s disability status was then changed from total to partial, shortening the length of time she could receive Workers’ Compensation benefits.
    Process Declared Unconstitutional
    In the injured worker’s appeal, she claimed that the General Assembly’s right to delegate the authority to establish the criteria for evaluating permanent impairment was unconstitutional. The Pennsylvania Workers’ Compensation Board rejected her claim, but the court then reversed its decision and ruled in agreement with the worker. Currently, the Pennsylvania Supreme Court holds that such power to delegate is unconstitutional on the basis that by law, all legislative power must be vested in the General Assembly, which consists of a Senate and a House of Representatives. In other words, the General Assembly must establish the criteria for physicians to follow when evaluating injuries for Workers’ Compensation claims, rather than outsourcing it to the American Medical Association or another entity.
    Evaluating an Injury for a Workers’ Compensation Claim
    By law, employers can request that employees seeking Workers’ Compensation benefits have their injuries evaluated by doctors to determine their level of impairment. An employer could do this once a worker received at least 104 weeks’ worth of total disability benefits. Physicians gave the injured workers impairment ratings, which were used to determine the length of their compensation periods and the type of work they could perform. It is important to note that the Workers’ Compensation Impairment Rating Evaluation is not the same as the Independent Medical Exam (IME), which is the initial medical examination that yields the worker’s diagnosis and treatment plan.
    The issue with the old evaluation model is that it was very rigid. If a physician determined that a worker’s impairment level was less than 50 percent, the worker’s disability status could be changed to partial disability, which they can collect for up to 500 weeks, or roughly nine years. In this scenario, a worker who cannot perform self-sustaining work could potentially have their impairment status changed and face financial difficulties once their partial disability benefits expire. Changing a worker’s disability status from total to partial did not affect the amount of compensation they received, but it did limit how long they could receive it, regardless of their actual work ability.
    Philadelphia Workers’ Compensation Lawyers at The Law Office of Jeffrey S. Gross Help Injured Workers Maximize their Claims
    Filing and pursuing a Workers’ Compensation claim can be a complicated process. While you are recovering from your injury, let an experienced Philadelphia Workers’ Compensation lawyer handle the legal aspects of your claim so you can focus on your health. Complete our online contact form or call 267-589-0090 or 215-512-1500 today to schedule your initial consultation at the Law Office of Jeffrey S. Gross. Our office is located in Philadelphia and we work with clients from the Greater Philadelphia area.