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Petrillo & Goldberg on Rise in Workers’ Compensation Claim Costs Due to Pennsylvania’s Supreme Court Impairment Valuation Ruling

Dec 11, 2018

Pennsauken, NJ (Law Firm Newswire) December 11, 2018 – Experts say that due to the state Supreme Court’s impairment valuation ruling, employers in Pennsylvania will likely be subject to a rise in workers’ compensation claim costs. In June 2017, the Pennsylvania Supreme Court quashed the state’s impairment rating evaluation process on the basis that it is unconstitutional. The court held that the General Assembly unconstitutionally assigned to the American Medical Association the power to establish guidelines for assessing permanent impairment.

In cases where a doctor decides the extent of an injured employee’s impairment pursuant to the Pennsylvania Workers’ Compensation Act, employers can ask for an impairment evaluation. The provision mandated that doctors apply the methodology from the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment. The law had been in effect since 1996.

Prominent South Jersey workers’ compensation attorneys Petrillo & Goldberg state, “It has now become more challenging for employees who have been injured at work to find the most effective physician who can correctly diagnose their level of impairment.” “An injured employee who is dissatisfied with their diagnosis should contact a workers’ compensation attorney.”

As was reported in Business Insurance, in 2007, Mary Ann Protz suffered a work-related knee injury and started to receive temporary total disability benefits from her employer. A doctor assigned Protz a 10 percent impairment rating on the basis of the AMA guide, and her employer filed a petition to modify her disability status from total to partial, which would reduce the length of time she received workers’ compensation benefits.

Protz filed an appeal with the Workers’ Compensation Appeal Board, contending that it was unconstitutional for the General Assembly to assign to the AMA the power to create guidelines for assessing permanent impairment. However, the board disputed this argument. But, the commonwealth court issued a reversal of that decision on appeal, and the Supreme Court of Pennsylvania concurred that the provision was unconstitutional.

The Pennsylvania Compensation Rating Bureau responded to the Supreme Court decision by filing a 6.06 percent loss cost increase. Due to the impairment evaluation rating (IRE) process, several claims were settled long before the 104 weeks arose. An IRE can be requested when an injured worker receives disability pay for 104 weeks. The IRE had a significant impact on claims, the potential for settlement and the settlement amount. Now that the IRE process is no longer in effect, costs will likely rise, and there will be an increase in claims that will become permanent.

Petrillo & Goldberg Law

6951 North Park Drive
Pennsauken, NJ 08109

19 South 21st Street
Philadelphia, PA 19103

70 South Broad Street
Woodbury, NJ 08096

Phone: 856-486-4343
Fax: 856:486-7979

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