The Nebraska Supreme Court ruled that the term “physician” does not include physician assistants, and so the state’s Workers’ Compensation Court did not err in disregarding a medical report regarding impairment rating that was signed by an orthopedic surgeon’s physician assistant and not the surgeon. They also declined to modify an employee’s impairment rating based on other factors.

John J. Bower worked for the Eaton Corporation as a relief operator and injured his right shoulder on September 30, 2013 in an incident related to his employment. He reported the incident that day but continued working through the end of the day. He woke up the next day in severe pain and nonsurgical treatments did not alleviate his pain, so he was referred to orthopedic Dr. Heber Crockett who diagnosed him with a moderate partial rotator cuff tear. Between February 2014 and December 2015 Bower underwent four surgeries along with physical therapy, steroid injections and medications. Eaton did not pay workers’ compensation benefits during this time.

Bower filed a workers’ comp claim on February 24, 2015 and reached maximum medical improvement on June 6, 2016. He underwent an independent medical examination conducted by Dr. Michael Morrison on July 7, 2016 who determined he suffered from a permanent 12 percent impairment as a result of the injury. Eaton determined that three of his four surgeries were compensable and paid temporary total disability benefits for the period between his surgeries and paid permanent partial disability benefits based on Morrison’s assessment. Eaton fired Bower on September 1, 2016 because they claimed they could not accommodate the work restrictions for his injury. Bower petitioned for temporary total disability benefits, vocational rehabilitation, payment of past and future medical bills, waiting-time penalties and attorney fees.

Bower had suggested his permanent disability benefits should be calculated based upon impairment to the body as a whole. The court only saw a report submitted by Crockett’s physician assistant, Yuji Kitabatake which suggested a 15 percent permanent impairment rating, and the court gave it no weight as the report failed to qualify as an expert medical opinion to rely on for a determination of workers’ comp benefits. Crockett had not signed the report. Also, Bower had failed to show substantial details on his own out-of-pocket expenses and the court relied on a physician’s testimony that no further medical treatments for his work-related injury would be necessary, so they declined to award him payments for future medical bills.

The Supreme Court upheld the ruling of the lower court that his impairment was to his right upper extremity and had not manifested itself to become a whole body impairment. The Supreme Court also agreed with the lower court who ruled that $7,500 was enough to cover attorney fees and his vocational rehabilitation service award was in line with state laws.

Read the case here.