HILL v. AMERICAN MEDICAL RESPONSE
423 P.3d 1119
| Okla. | 2018Background
- Robert Hill, a paramedic, injured his right shoulder at work in 2014, underwent surgery, reached MMI, and filed for permanent partial disability (PPD) benefits under the AWCA.
- Employer submitted an evaluating physician report (Dr. Gillock) rating Hill at 4.2% whole-person impairment under the AMA Guides, Sixth Edition; Hill's doctor (Dr. Wilson) gave 8% under Sixth Edition and 31.8% under Fifth Edition.
- At the PPD hearing Hill moved to exclude Employer's report under Daubert and challenged the constitutionality of AWCA provisions mandating use of the AMA Guides, Sixth Edition (arguing separation-of-powers, predetermination, non-delegation, due process, and access-to-courts violations).
- The ALJ admitted Dr. Gillock's report, awarded 7% whole-person impairment ($7,913.50); the Workers' Compensation Commission affirmed and Hill appealed to the Oklahoma Supreme Court.
- The Supreme Court affirmed: ALJ did not err admitting the report; mandatory use of the AMA Guides, Sixth Edition (as the edition in force when the statute was enacted) is constitutional; the Court declined to resolve broader policy complaints about the shrinking "grand bargain."
Issues
| Issue | Hill's Argument | American Medical Response / State's Argument | Held |
|---|---|---|---|
| Admissibility of employer's physician report (Daubert/relevance) | Gillock's report is irrelevant because AMA Guides address "impairment," not "disability," so it fails Federal Rule 702/Daubert | AWCA incorporates AMA Guides into statutory definition of "permanent disability"; expert testimony meeting §72(D)/FRE 702 is admissible | ALJ did not err; report admissible because statute ties "permanent disability" to AMA impairment ratings |
| Mandatory use of AMA Guides: separation-of-powers / predetermination | Legislature by mandating the Guides improperly restrains ALJs and predetermines adjudicative scientific facts | Legislature may set evidentiary standards; statute does not fix weight of any report or predetermine individual impairment | Use of the Guides as the evidentiary standard does not impermissibly intrude on adjudicative fact-finding |
| Non-delegation: reference to "current/most current edition" | Phrase delegates legislative power to AMA (or future editors), unconstitutional | Proper construction: refer to the edition current when statute was enacted (Sixth Edition), avoiding delegation | Statute construed to mean the edition effective at enactment (Sixth Edition); no unlawful delegation |
| Due process / access to courts / substantive due process / grand bargain | Use of the Guides deprived Hill of procedural (e.g., cross-examine authors) and substantive due process and denies access to justice; results in unfair, diminished awards | Hill had notice, a hearing, and opportunity to challenge medical evidence; uniform standards further legitimate state interests | Procedures satisfied due process; mandatory Guides rationally related to uniformity interest; policy complaints belong to Legislature |
Key Cases Cited
- Daubert v. Merrell Dow Pharm., 509 U.S. 579 (U.S. 1993) (sets admissibility factors for expert testimony under FRE 702)
- Christian v. Gray, 65 P.3d 591 (Okla. 2003) (discussing Daubert factors in Oklahoma context)
- Maxwell v. Sprint PCS, 369 P.3d 1079 (Okla. 2016) (addressing PPD definitions and limits on statutory deferral provisions)
- Lee v. Bueno, 381 P.3d 736 (Okla. 2016) (legislature may set rules of evidence; limits on predetermination challenges)
- Yocum v. Greenbriar Nursing Home, 130 P.3d 213 (Okla. 2005) (legislative provisions cannot predetermine adjudicative facts)
- Conaghan v. Riverfield Country Day School, 163 P.3d 557 (Okla. 2007) (invalidating statutory provisions that unduly restrict judicial factfinding)
- Protz v. Workers' Comp. Appeal Bd., 161 A.3d 827 (Pa. 2017) (analyzing non‑delegation and meaning of "most recent edition" language)
- Cline v. Oklahoma Coalition for Reproductive Justice, 368 P.3d 1278 (Okla. 2016) (construing statutes to avoid unconstitutional delegation)
- Torres v. Seaboard Foods, 373 P.3d 1057 (Okla. 2016) (substantive due process test for economic legislation; review of AWCA changes)
- McCabe v. North Dakota Workers Comp. Bureau, 567 N.W.2d 201 (N.D. 1997) (construing "most current edition" to mean edition at time of enactment)
- Sterling Refining Co. v. Walker, 25 P.2d 312 (Okla. 1933) (limits on legislature delegating powers; distinguished here)
