In a 6-1 ruling last month, the Pennsylvania Supreme Court struck down a section of the state’s workers’ compensation law that allowed insurance companies to stop paying benefits to injured workers after a certain amount of time had passed.
This section of the law was added in 1996 and allowed workers’ compensation insurance companies to send a claimant to an exam with a licensed doctor to determine whether his or her impairment level was below 50 percent, according to guidelines set by the American Medical Association (AMA).
If the doctor determined that a workers’ rating was below 50 percent, the law allowed insurance companies to stop paying benefits after 500 weeks, regardless of the worker’s health issues.
The Pennsylvania Supreme Court declared this section of the law to be unconstitutional because the legislature was delegating too much authority to the AMA, a private entity.
If you filed a workers’ compensation claim in the past 20 years and it was affected by this provision, you may have legal options. Contact the Harrisburg workers’ compensation lawyers at Schmidt Kramer for a free legal consultation.
More Details on the Ruling
The court ruling resolved a lawsuit filed in 2011 by a school district employee who suffered complications after surgery for an on-the-job knee injury. The employee’s injury was rated at just 10 percent and her benefits were discontinued.
Her lawsuit alleged that using the AMA’s injury ratings constituted an illegal delegation of power by Pennsylvania’s General Assembly.
The state supreme court agreed, with one justice writing that this section of the law did not require the AMA to:
- Hold hearings
- Accept public comment
- Explain grounds for its methodology in a reasoned opinion, which could be subject to judicial review
This meant that the assembly could not control the AMA methodology or apply it fairly, according to the justice.
What Does This Mean for You?
The ruling means that insurance companies can no longer use AMA guidelines to rate work injuries and cut off benefits after 500 weeks. This gives workers with severe injuries a much better chance of obtaining the long-term benefits they need to manage their condition.
If you filed a claim while this section of the law was in effect and it was used to cut off your benefits, it is unclear if you can file another claim to obtain compensation.
However, by not addressing this issue, the Supreme Court may have left the door open to re-filing a claim. That is why you should contact a workers’ compensation lawyer right away to determine your options.
Contact Schmidt Kramer Today for a Free Consultation
Our personal injury attorneys in Harrisburg have decades of combined experience helping injury victims obtain fair compensation for the damages they have suffered.
If you suffered an on-the-job injury, our lawyers can help you file a workers’ compensation claim and handle any appeals. Our goal is to help you obtain all the types of workers’ compensation benefits you are entitled.
We have in-depth knowledge of workers’ compensation laws and how they apply to your claim.
Complete a Free Case Evaluation form or call (717) 888-8888 right now.