PA Supreme Court Rules Portion of the Workers’ Compensation Act is Unconstitutional

Part of the Pennsylvania Workers’ Compensation Act was found to be unconstitutional by the state Supreme Court, who ruled that physicians conducting impairment-rating evaluations on patients

Mary Ann Protz brought her case to the court when her knee injury at work caused her to receive temporary total disability benefits. Her employer, the Derry Area School District, asked her to undergo an impairment-rating evaluation (IRE) and she was assigned a 10 percent impairment rating. The doctor had used the most recent edition of the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment as was required in the state workers’ compensation act. Because her assigned impairment rating was less than 50 percent her employer filed to modify her disability from total to partial and their request was granted. She appealed, arguing that the General Assembly was acting unconstitutionally by leaving the authority to establish the criteria for evaluating impairment to the AMA.

Though the General Assembly is allowed to delegate authority to an independent agency to execute and administer laws, it’s only appropriate in certain situations. There are two stipulations, the policy must be made by the legislature and the legislation must include standards to guide and restrain this delegation of power. But in this case the General Assembly gave the AMA all the authority to implement their own policies and standards, which were adopted and followed. The requirement was that physicians use the most recent edition of the AMA Guides. The problem is that those Guides could be updated by the AMA without input or review from the state General Assembly.

The AMA is a private organization and not an independent agency or executive branch agency, they are not required to hold hearings, listen to public comments, or explain the grounds for their methodology subject to judicial review.

The Supreme Court ruled that the General Assembly of Pennsylvania should make the laws, and not let legislation be written by other parties. The required process they had been using for impairment rating evaluations was unconstitutional since the AMA had written the criteria; it violated the non-delegation doctrine of the Pennsylvania Constitution.

Read more here and more from the Insurance Journal here

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