Protz, M., Aplt. v. WCAB (Derry Area SD)
Protz, M., Aplt. v. WCAB (Derry Area SD) - No. 6 WAP 2016
| Pa. | Jun 20, 2017Background
- Mary Ann Protz, a workers' compensation claimant, challenged Section 306(a.2) of the Workers' Compensation Act, 77 P.S. § 511.2, which requires impairment ratings be determined pursuant to the most recent edition of the AMA Guides.
- Section 306(a.2) directs that after 104 weeks of total disability, an insurer-requested exam by a licensed, board-certified, actively practicing physician must determine impairment under the most recent AMA Guides; a 50%+ impairment presumes total disability.
- The Commonwealth Court held Section 306(a.2) unconstitutional as an unlawful delegation of legislative power to the AMA; the decision vacated the Workers’ Compensation Appeal Board order and remanded.
- Justice Baer dissented from the Supreme Court majority, arguing the statute does not delegate legislative authority to the AMA but instead directs physicians to apply an objective, up-to-date medical standard.
- Baer emphasized the Legislature made the core policy choices (who evaluates, qualifications, and use of a uniform standard) and that adopting an evolving medical standard is practical and preserves accurate impairment evaluations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether § 306(a.2) unlawfully delegates legislative power by adopting the "most recent" AMA Guides | Protz: statute impermissibly delegates lawmaking to a private entity by tying legal consequences to the AMA Guides | Derry Area SD: statute sets policy and delegates only factfinding to qualified physicians who must use an objective, current medical standard | Dissent (Baer): statute is constitutional; it directs an objective standard to physicians and does not delegate legislative power |
| Whether use of a privately published, periodically revised standard is inherently delegatory | Protz: periodic revisions transfer legislative authority to AMA | Derry: practical necessity—Legislature may adopt expert standards to reflect medical advances | Baer: adopting evolving expert standards is permissible and avoids inaccurate impairment ratings |
| Whether the Legislature supplied adequate standards and restrained delegated functions | Protz: statute lacks sufficient legislative guidance if it defers to AMA revisions | Derry: Legislature defined evaluator qualifications and the legal consequences (50% threshold), supplying adequate standards | Baer: Legislature made the basic policy choices and restrained delegation via physician qualifications and statutory thresholds |
| Broader impact on statutes referencing current external standards | Protz: ruling supports invalidating other statutory references to external standards | Derry: invalidation would disrupt many statutes relying on expert-devised standards | Baer: majority’s contrary view risks widespread negative consequences for statutes that rely on up-to-date expert standards |
Key Cases Cited
- W. Mifflin Area Sch. Dist. v. Zahorchak, 4 A.3d 1042 (Pa. 2010) (Legislature must make basic policy choices)
- Lehman v. Pa. State Police, 839 A.2d 265 (Pa. 2003) (separation of powers and limits on delegation)
- Pennsylvanians Against Gambling Expansion Fund v. Commonwealth, 877 A.2d 383 (Pa. 2005) (Legislature must supply adequate standards to guide delegated functions)
- Protz v. Workers' Comp. Appeal Bd. (Derry Area Sch. Dist.), 124 A.3d 406 (Pa. Cmwlth. 2015) (Commonwealth Court holding §306(a.2) unconstitutional)
- Madrid v. St. Joseph Hospital, 928 P.2d 250 (N.M. 1996) (upholding statutory adoption of periodically revised AMA Guides as non-delegatory)