New PA workers’ compensation proposal gains momentum

Lawmakers are attempting to bring back the IRE.

Pennsylvania lawmakers are considering a recent proposal to reform the state's workers' compensation system.

Why are lawmakers looking to change the state's workers' comp law? The Pennsylvania Supreme Court recently ruled on a case that changed the way in which employers and insurance carriers attempt to cut off injured workers' wage loss benefits.

The case, Protz v. Workers Compensation Appeal Board (Derry Area School District), involved a woman who suffered a knee injury while on the job. The employer paid the injured employee workers' comp benefits but, after 104 weeks, requested an Impairment Rating Evaluation (IRE) under the then-current law, and the physician performing the evaluation gave her a 10 percent impairment rating based on the pertinent American Medical Association (AMA) Guidelines to Permanent Impairment. Under the law, the rating resulted in a change to her disability status from full disability to partial. Since partial disability only lasts for 500 weeks in Pennsylvania, the IRE effectively capped her wage loss benefits.

Ms. Protz challenged the law governing the IRE procedure. Ultimately, the PA Supreme Court ruled in her favor. It held that the Pennsylvania Legislature could not cede legislative authority to the American Medical Association (AMA) to determine the employee's level of impairment, and found the IRE process unconstitutional.

A more thorough review of this ruling is available here.

What is the proposal? Due to this ruling, employers can no longer request an IRE. The proposal aims to restore method of cutting off a claimant's benefits within the bounds of the law.

How would the proposal achieve this goal? The proposal provides a schedule of compensation and computation of benefits as well as guidelines for the physical examination or expert interview. Those in favor of the proposal argue it should move forward as the courts did not express concern with the IRE process itself. Instead, the court disagreed with the method used to update the standards used to determine the degree of impairment. Those opposed note the proposal would attempt to override the court's efforts and limit an injured worker's right to receive ongoing benefits.

If passed, the proposal would recognize the Sixth Edition of the AMA Guidelines as valid. It also states that a disability rating of 35 percent or higher would equal permanent disability, and 35 percent or lower would be deemed partial disability.

What is the status of the proposal? The Pennsylvania House of Representatives recently voted to pass the proposal. It is currently under consideration within the Senate.

What does this mean for injured workers in Pennsylvania? Right now, the Pennsylvania Department of Labor and Industry notes that due to the court's decision it is no longer designating physicians to perform IREs. However, if this proposal continues with its forward momentum and becomes a law, IREs could begin again in the near future.

It is also important to note that even if the law passes, it could face legal challenges. Injured workers could fight back against the new law in much the same way they fought against the previous version of the law. Contact our office today if you have questions about an ongoing case or how the IRE law affects you.