Doctor must evaluate impairment under current edition of AMA Guides
Birk v. Charming Shoppes, 26 PAWCLR 37 (Pa. W.C.A.B. 2011).
Ruling: The Pennsylvania Workers' Compensation Appeals Board vacated the workers' compensation judge's grant of the employer's modification petition. The board sent the case back for further consideration.
What it means:
The degree of a claimant's impairment must be determined based on an evaluation by a physician pursuant to the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment.
Summary: The board found that the WCJ erred in granting the modification petition because the impairment rating evaluation physician determined the claimant's impairment rating using the wrong edition of the AMA Guides. The WCJ granted the employer's modification petition, finding that the claimant reached maximum medical improvement and had a whole body impairment rating of 18 percent. The board concluded that the WCJ erred in accepting the physician's impairment rating evaluation based upon the 5th edition of the AMA Guides.
The 6th edition was issued five months before the physician performed the IRE using the 5th edition. Although the physician did not perform the IRE using the most current edition as statutorily required, the board found this was a unique situation because the IRE was performed before it would be feasible for a doctor to be trained and certified in the most current edition, which is required under the regulations.
The board sent the case back for the WCJ to permit the employer to have the claimant submit to a new IRE in which the impairment rating would be calculated under the most recent edition of the AMA Guides.
Read more at the WorkersComp Forum homepage.
May 19, 2011
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