Duffey, M., Aplt. v. WCAB (Trola-Dyne, Inc.)
4 MAP 2016
| Pa. | Jan 19, 2017Background
- Michael C. Duffey filed a workers’ compensation claim; employer (Trola‑Dyne) issued a Notice of Compensation Payable (NCP) that described physical injury but did not initially include later‑manifesting psychological conditions (PTSD, adjustment disorder).
- An impairment rating evaluation (IRE) was conducted before Duffey obtained amendment of the NCP to add the psychological injuries.
- The Commonwealth Court and Workers’ Compensation Appeal Board affirmed that the post‑IRE amendment could affect the IRE; the Pennsylvania Supreme Court majority held impairment evaluators must determine the degree of impairment "due to the compensable injury," including impairments "fairly attributable" to it, even if not previously accepted.
- Justice Wecht filed a dissent arguing the majority misreads 77 P.S. § 511.2(1), the statutory and AMA definitions of "impairment," and the AMA Guides; he contends IREs should quantify permanent loss from accepted compensable injuries only.
- Wecht warns the majority’s approach shifts causation fact‑finding from WCJs to physicians, undermines the NCP’s binding scope absent modification, and conflicts with precedent (e.g., Commercial Credit Claims) and with concerns raised in Protz about the Guides' role.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether an IRE conducted before an NCP amendment is invalidated by a later expansion of accepted injuries | Duffey: post‑IRE amendment should be able to affect the prior IRE; employer can obtain a new IRE if needed | Trola‑Dyne: amendment does not retroactively invalidate an earlier IRE; claimant should petition to amend before IRE or challenge status during the 500‑week period | Majority: IRE physician must determine impairments "due to" compensable injury and may assess conditions "fairly attributable" to it (even if not previously accepted); (Wecht dissent disagrees) |
| Whether impairment evaluators must assess psychological conditions not listed on the NCP | Duffey: physician assessments can capture whole‑person impairment including psychiatric effects fairly attributable to the injury | Trola‑Dyne: psychological conditions separate from accepted physical injury require NCP modification and claimant bears burden to prove causation | Majority: evaluators may consider mental conditions under the Guides if fairly attributable; (Wecht dissent: evaluators should be limited to injuries listed on NCP and mental disorders should not be rated absent acceptance) |
| Whether the AMA Guides (6th ed.) control scope of IREs and permit psychiatric percentage ratings | Duffey: current Guides provide tools to convert conditions into whole‑person impairment, including mental chapters | Trola‑Dyne: reliance on Guides cannot override statutory limits or NCP scope | Majority: relies on Sixth Edition language to permit whole‑person analysis including mental factors; (Wecht dissent: Fourth Edition (in effect when statute enacted) did not support percentage ratings for mental disorders and Protz casts doubt on Sixth Edition adoption) |
| Whether the change relieves claimant of burden to prove causation for newly alleged injuries | Duffey: allowing evaluators to determine what is fairly attributable reduces procedural burdens and need for pre‑IRE petitions | Trola‑Dyne: claimant must prove causation for injuries not accepted by NCP; employer should not be forced to disprove causation | Majority: places more causal assessment burden on physicians (Wecht dissent: this improperly shifts fact‑finding from WCJs to physicians and upends NCP finality) |
Key Cases Cited
- Protz v. W.C.A.B. (Derry Area School Dist.), 124 A.3d 406 (Pa. Cmwlth. 2015) (commonwealth court decision holding statutory delegation constitutional issue and directing use of Fourth Edition of AMA Guides)
- Commercial Credit Claims v. W.C.A.B. (Lancaster), 728 A.2d 902 (Pa. 1999) (NCP limits scope of employer’s stipulated liability; separate psychological injury outside NCP requires claimant to seek modification)
- Payes v. W.C.A.B. (State Police), 79 A.3d 543 (Pa. 2013) (discussion of mental‑mental injury concept)
- Panyko v. W.C.A.B. (U.S. Airways), 888 A.2d 724 (Pa. 2005) (definition of "injury" is broad)
- Cerro Metal Products Co. v. W.C.A.B. (PLEWA), 855 A.2d 932 (Pa. Cmwlth. 2004) (ambiguously described NCP construed in claimant’s favor)