Pennsylvania Expands Extent of Workers Compensation Wage Loss Benefits

Since mid-1996, Pennsylvania has permitted workers compensation insurance companies and self-insured employers to limit the duration of wage loss benefits available to disabled workers by permitting special medical examination, called Impairment Rating Exams, to achieve a reduction in a worker’s status from total to partially disabled.

This is how it worked. The injured worker would be scheduled for an examination with a physician deemed eligible for this purpose by the state and the exam would cover only the acknowledged work- related injuries, applying measurements and techniques as prescribed in the American Medical Association’s Guide to the Evaluation of Permanent Impairment.

The examiner would then complete a prescribed form and render a determination as to the worker’s percentage of whole body impairment.

Pennsylvania had the highest impairment ceiling in the United States, which simply meant that unless a worker were determined to be at least 50% impaired as a whole person, he/she could no longer remain on total disability but would become legally partially disabled.

The impact of this part of the law was very significant.

While the new disability status of partially disabled did not allow any actual reduction in the weekly amount of benefits, it did place a limit of an additional 500 weeks of wage loss benefits.

Over the ensuing 20 years or so, many workers and their counsel raised issues with this part of the Pennsylvania Law because many of us believed the Pennsylvania legislature had illegally granted its lawmaking power to that of a private organization, the AMA. Fortunately, the Pennsylvania Supreme Court has agreed and in the case of PROTZ V. W.C.A.B. (Derry Area School District), it struck down the entire Impairment rating process as unconstitutional.

Now, Pennsylvania is back where it was prior to the 1996 changes. Now, technically, an injured worker can remain on Workers’ Compensation wage loss benefits indefinitely. This is surely very good news forthose injured in the future.

What remains unresolved in Pennsylvania is whether the Court’s opinion in the Derry case applies fully retroactively to invalidate ALL Impairment rating evaluations that have not resulted in full releases of the cases.

This issue of retro-activity is now before the Pennsylvania Commonwealth Court, another appeals court, for determination.

In the immediate present, we are filing petitions on ALL cases where I believe the Derry case may well reverse my client’ partial disability status, thus allowing them to, again, be eligible for potentially indefinite workers compensation wage loss benefits.

If you are an injured worker eligible for benefits under Pennsylvania law, whose benefits have been reduced in duration by a now illegal impairment rating examination, I recommend that you consult an experienced and competent Pennsylvania workers
compensation attorney.

Learn more about:  Workers’ Compensation

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