Many Pennsylvanians may not realize that the American Medical Association's Guides to the Evaluation of Permanent Impairment are used to determine their workers' compensation benefits. Since these guidelines are updated and changed from time to time, a person who suffers a work-related injury or illness that makes him or her eligible for disability benefits needs to make sure that his or her benefits are being paid in accordance with the correct version of the AMA guidelines. While it might seem like the most current ones would be applicable, the Commonwealth Court of Pennsylvania just ruled differently.
The case that brought about the ruling involves a woman who suffered a knee injury while employed by the Derry Area School District in 2007. She initially received workers' compensation until she returned to her job later in the year. The following year, the injury recurred. Her benefits were reinstated, but her impairment was determined to be just 10 percent under the AMA guidelines at that time. Anything under 50 percent is considered a partial disability.
The school district later sought to reduce her benefits from covering a total disability to a partial disability. That request was approved by Pennsylvania's Workers' Compensation Appeals Board.
The appellate court, however, ruled that the stipulation in the Pennsylvania Workers' Compensation Act that allows the most current version of the AMA's guidelines to be used is unconstitutional. That, according to the court, is because it didn't allow for a review of changes to the guidelines. In some cases, the impairment rating for the same injury could change with each guideline revision.
In its decision, the court noted, "There is no accountability to the public, either directly through the rulemaking process providing for public input and comment or indirectly through the appointment and confirmation power and the power of the purse."
Anyone who suffers a work-related injury or illness can find dealing with the workers' compensation process confusing and frustrating. It's important to remember that it's often in the best interests of the workers' compensation board and your employer to keep your benefits as low as possible. That's why if you believe that you are not being correctly or sufficiently compensated for an injury or illness, it's wise to consult a Pennsylvania workers' compensation attorney who knows the state laws and can work to protect your interests and right to fair compensation.
Source: Business Insurance, "AMA injury guides used in unconstitutional manner, court rules," Gloria Gonzalez, Sep. 21, 2015