M.A. Protz v. WCAB (Derry Area SD)

CourtCommonwealth Court of Pennsylvania
DecidedSeptember 18, 2015
Docket1024 C.D. 2014
StatusPublished

This text of M.A. Protz v. WCAB (Derry Area SD) (M.A. Protz v. WCAB (Derry Area SD)) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
M.A. Protz v. WCAB (Derry Area SD), (Pa. Ct. App. 2015).

Opinion

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Mary Ann Protz, : Petitioner : : v. : : Workers’ Compensation Appeal : Board (Derry Area School District), : No. 1024 C.D. 2014 Respondent : Argued: April 15, 2015

BEFORE: HONORABLE DAN PELLEGRINI, President Judge HONORABLE BERNARD L. McGINLEY, Judge HONORABLE BONNIE BRIGANCE LEADBETTER, Judge HONORABLE ROBERT SIMPSON, Judge HONORABLE MARY HANNAH LEAVITT, Judge HONORABLE PATRICIA A. McCULLOUGH, Judge HONORABLE ANNE E. COVEY, Judge

OPINION BY PRESIDENT JUDGE PELLEGRINI FILED: September 18, 2015

Mary Ann Protz (Claimant) petitions for review of the order of the Workers’ Compensation Appeal Board (Board) affirming the decision of the Workers’ Compensation Judge (WCJ) which granted Derry Area School District’s (Employer) petition to modify Claimant’s benefits (modification petition) from total to partial disability under Section 306(a.2) of the Workers’ Compensation Act (Act).1 Because we find Section 306(a.2) of the Act unconstitutional pursuant to

1 Act of June 2, 1915, P.L. 736, as amended, 77 P.S. §511.2, added by the Act of June 24, 1996, P.L 350. Article II, Section 1 of the Pennsylvania Constitution, we vacate and remand for further proceedings.

I. The following facts are not in dispute. In April 2007, Claimant sustained a work injury to her right knee when she fell while working for Employer, and Employer issued a notice of temporary compensation payable. When Claimant returned to work in August 2007, her benefits were suspended pursuant to Employer’s notice of suspension. In February 2008, Claimant’s work injury recurred, and her benefits were reinstated as per a supplemental agreement.

Subsequently, Employer filed a request for designation of a physician to perform an impairment rating evaluation (IRE), following which Jeffrey M. Moldovan, D.O. evaluated Claimant in October 2011 and provided a ten-percent impairment rating under the Sixth Edition of the American Medical Association’s (AMA) Guides to the Evaluation of Permanent Impairment (Guides).2 In April 2012, Employer filed a modification petition, seeking to convert Claimant’s total disability benefits to partial disability benefits thereby reducing the amount of

2 Dr. Moldovan previously evaluated Claimant in December 2009, but could not perform an IRE as Claimant had not yet obtained maximum medical improvement from her work injury. Following the second IRE, in November 2011, Employer issued a notice of change of workers’ compensation disability status, changing Claimant’s status from total to partial disability, effective the date of Dr. Moldovan’s IRE. Claimant then filed a petition to review compensation benefits, alleging an incorrect description of her work injury and challenging Employer’s unilateral conversion of her total disability benefits. The WCJ issued an order finding that Employer was not entitled to automatically convert Claimant’s total disability benefits to partial disability benefits and setting aside Employer’s notice of change of workers’ compensation disability status.

2 compensation that can be paid to 500 weeks. See Section 306(a.2)(7) of the Act, 77 P.S. §511.2(7) (“In no event shall the total number of weeks of partial disability exceed five hundred weeks for any injury or recurrence thereof, regardless of the changes in status in disability that may occur….”).

A claimant is partially disabled if he or she has a total impairment rating of less than fifty percent. See Section 306(a.2)(2) of the Act, 77 P.S. §511.2(2). The impairment rating is determined pursuant to Section 306(a.2) of the Act, providing that it shall be determined under “the most recent edition of the American Medical Association ‘Guides to the Evaluation of Permanent Impairment,’” which provide a percent of impairment for each particular injury. 3

3 Section 306(a.2) of the Act provides:

(1) When an employe has received total disability compensation pursuant to clause (a) for a period of one hundred four weeks, unless otherwise agreed to, the employe shall be required to submit to a medical examination which shall be requested by the insurer within sixty days upon the expiration of the one hundred four weeks to determine the degree of impairment due to the compensable injury, if any. The degree of impairment shall be determined based upon an evaluation by a physician who is licensed in this Commonwealth, who is certified by an American Board of Medical Specialties approved board or its osteopathic equivalent and who is active in clinical practice for at least twenty hours per week, chosen by agreement of the parties, or as designated by the department, pursuant to the most recent edition of the American Medical Association “Guides to the Evaluation of Permanent Impairment.”

(2) If such determination results in an impairment rating that meets a threshold impairment rating that is equal to or greater than fifty per centum impairment under the most recent edition of the American Medical Association “Guides to the Evaluation of Permanent Impairment,” the employe shall be presumed to be totally disabled and shall continue to receive total disability (Footnote continued on next page…)

3 (continued…) compensation benefits under clause (a). If such determination results in an impairment rating less than fifty per centum impairment under the most recent edition of the American Medical Association “Guides to the Evaluation of Permanent Impairment,” the employe shall then receive partial disability benefits under clause (b): Provided, however, That no reduction shall be made until sixty days’ notice of modification is given.

(3) Unless otherwise adjudicated or agreed to based upon a determination of earning power under clause (b)(2), the amount of compensation shall not be affected as a result of the change in disability status and shall remain the same. An insurer or employe may, at any time prior to or during the five hundred-week period of partial disability, show that the employe’s earning power has changed.

(4) An employe may appeal the change to partial disability at any time during the five hundred-week period of partial disability; Provided, That there is a determination that the employe meets the threshold impairment rating that is equal to or greater than fifty per centum impairment under the most recent edition of the American Medical Association “Guides to the Evaluation of Permanent Impairment.”

(5) Total disability shall continue until it is adjudicated or agreed under clause (b) that total disability has ceased or the employe’s condition improves to an impairment rating that is less than fifty per centum of the degree of impairment defined under the most recent edition of the American Medical Association “Guides to the Evaluation of Permanent Impairment.”

(6) Upon request of the insurer, the employe shall submit to an independent medical examination in accordance with the provisions of section 314 to determine the status of impairment: Provided, however, That for purposes of this clause, the employe shall not be required to submit to more than two independent medical examinations under this clause during a twelve-month period.

(7) In no event shall the total number of weeks of partial disability exceed five hundred weeks for any injury or recurrence thereof, regardless of the changes in status in disability that may occur. In no event shall the total number of weeks of total disability exceed (Footnote continued on next page…)

4 When the Act was enacted, the Fourth Edition of the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (Guides) was in effect but at the time of Claimant’s examination, the most current version (the Sixth Edition) was being used. Each edition can change the impairment rating for the same injury.

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M.A. Protz v. WCAB (Derry Area SD), Counsel Stack Legal Research, https://law.counselstack.com/opinion/ma-protz-v-wcab-derry-area-sd-pacommwct-2015.