IRE in PA Workers’ Comp Must Use Most Recent Edition of AMA Guides

As noted in the previous blog posting, the PA Workers’ Compensation Act mandates that an Impairment Rating Evaluation (IRE) must be performed using the “most recent edition” of the American Medical Association’s Guides to the Evaluation of Permanent Impairment. The most recent edition is the Sixth Edition, published around January 2008.

The Pennsylvania Bureau of Workers’ Compensation, in early 2008, stated that it would accept an IRE performed under the Fifth or Sixth Editions until September 1, 2008, to give IRE physicians a chance to become certified under the new edition.

Whether this pronouncement by the PA Bureau of Workers’ Compensation was consistent with the Pennsylvania Workers’ Compensation Act was addressed by the Commonwealth Court of Pennsylvania in Stanish v. Workers Compensation Appeal Board (James J. Anderson Construction Co.).

In this case, an IRE was performed in April, 2008, using the Fifth Edition of the AMA Guides. Under the pronouncement by the PA Bureau of Workers’ Compensation, the Workers’ Compensation Judge (WCJ) found the IRE valid and granted the shift of total disability benefits to partial disability benefits as requested by the workers’ comp insurance carrier. This was affirmed by the Workers’ Compensation Appeal Board (WCAB).

On appeal, however, the Commonwealth Court of Pennsylvania reversed. The PA Workers’ Compensation Act specifically states that the “most recent edition” of the AMA Guides must be used. The pronouncement by the PA Bureau of Workers’ Compensation, that IRE physicians could still use the Fifth Edition, after the Sixth Edition was published, was inconsistent with the Act, and not valid. Since the IRE in the case at issue was performed using the Fifth Edition, after the date the Sixth Edition was published, the IRE did not use the “most recent edition,” and was therefore not valid.