Workers' Compensation Disability Standards Improper Delegation Article II, Section 1
Protz v. Workers' Compensation Appeal Bd., PICS Case No. 17-0963 (Pa. June 20, 2017) Wecht, J., Saylor, C. J. (concurring), Baer, J. (dissenting) (27 pages).
Commonwealth court properly held that the general assembly improperly delegated its powers and violated Art. II, 1 when it directed IRE physicians to use the "most recent edition" of the AMA Guides to the Evaluation of Permanent Impairment in determining a claimant's ratings impairment but court erred in remanding the case because 306(a.2) was unconstitutional in its entirety. Affirmed in part and reversed in part.
Appellant sustained a work-related knee injury in 2007 and her employer began paying temporary total disability benefits. Appellant underwent an IRE at employer's request in 2011. The IRE physician assigned her a 10 percent impairment rating based on the Guides to the Evaluation of Permanent Impairment. Employer filed a modification petition to convert appellant's disability status from total to partial. The WCJ granted the petition and appellant appealed, arguing that the general assembly unconstitutionally delegated to the AMA the criteria for evaluating permanent impairment. The board rejected appellant's contention and she appealed. The Commonwealth Court reversed the board's decision and agreed with appellant that the statute's requirement that physicians use "the most recent edition" of the guide violated Art. II, 1 by unconstitutionally delegating its power without first establishing primary standards to guide and restrain the exercise of the delegated functions. The court also noted that the AMA was a private organization with no accountability to the public. The commonwealth court declared the law unconstitutional "insofar as it proactively approved versions of the AMA Guides beyond the Fourth Edition without review" and remanded the case. Both parties appealed.
Employer argued that the general assembly could adopt standards that were published by an independent authority. Appellant asserted that the statute gave the AMA unfettered discretion over Pennsylvania's impairment-rating methodology. The general assembly did not favor any particular policies relative to the Guides' methodology for grading impairments and did not prescribe any standards to guide and restrain the AMA's discretion to create such a methodology. It gave the AMA de facto, unfettered control over a formula that determined whether a claimant's partial disability benefits would cease after 500 weeks. Additionally, the general assembly did not include any procedural mechanisms to protect against administrative arbitrariness and caprice. Furthermore, the fact that the delegation was to a private entity posed unique concerns since private entities were isolated from the political process and shielded from political accountability. The court found that 306(a.2) could not withstand constitutional scrutiny even if the AMA were a governmental body.