When a Pennsylvania employee is injured on the job, the employee is entitled to workers’ compensation benefits. If the accident results in a “total disability” (the employee is completely unable to work), he receives benefits equal to two-thirds (2/3) of his pre-injury average weekly wage. If the accident results in only a “partial disability” (employee can perform some duties, but with a loss in earnings), then the employee receives benefits equal to two-thirds (2/3) of the difference between his pre- and post-injury wages. The difference between a “total” and “partial” disability is important, for “partial” disability benefits are capped at 500 weeks, after which the benefits are terminated. Whereas “total” disability benefits can continue forever.
Section 306(a.2) of the Pennsylvania Workers’ Compensation Act provides that, after an employee receives total disability benefits for 104 weeks and reaches maximum medical improvement, the employer may request an Impairment Rating Evaluation (“IRE”), which requires a doctor to examine the employee and review the “most recent edition” of the American Medical Association (“AMA”) Guidelines. If, under those AMA Guidelines, the injury caused less than 50% whole body impairment, then the employee’s disability status may be changed from “total” to “partial” disability benefits. Very few claimants meet the 50% impairment level and therefore the IRE provision was a useful tool for employers to cut benefits.
In the recent Pennsylvania Supreme Court case of Protz v. Workers’ Compensation Appeal Board, which arises from the Derry Area School District, the Court struck down the IRE provisions of the Act finding that it was unconstitutional for the legislature to rely upon the AMA Guidelines as the criteria for determining an employee’s entitlement to benefits. The Court concluded that the legislature had improperly made a “broad and unbridled” delegation of its lawmaking powers to the AMA. As a result of this Court case, the IRE provisions of the Act are not enforceable and an employer is no longer able to rely upon the IRE process to change an employee’s status from “total” to “partial” disability.
For more information and a consultation regarding PA Workers’ Compensation Laws, contact our Law Firm, Supinka & Supinka, PC.