Protz v. Workers' Compensation Appeal Board
2015 Pa. Commw. LEXIS 404
Pa. Commw. Ct.2015Background
- In 2007 Mary Ann Protz injured her knee at work; she received temporary and then total disability benefits, with a recurrence and reinstatement in 2008.
- Employer requested an independent impairment rating evaluation (IRE); in 2011 Dr. Moldovan gave a 10% impairment under the AMA Guides (Sixth Edition).
- Under Section 306(a.2) of the Workers’ Compensation Act, impairment is determined using “the most recent edition” of the AMA Guides; an impairment below 50% converts total to partial disability (limited to 500 weeks).
- The WCJ granted Employer’s modification petition converting Claimant from total to partial disability based on the Sixth Edition rating; the Board affirmed.
- Claimant appealed, arguing Section 306(a.2) is an unconstitutional delegation of legislative power because it effectively lets the AMA (a private body) change the statutory standard by updating its Guides.
- The Commonwealth Court majority held Section 306(a.2) unconstitutional to the extent it adopts post‑1996 editions of the AMA Guides without legislative or governmental review, and remanded to apply the Fourth Edition (the edition in effect when the statute was enacted).
Issues
| Issue | Plaintiff's Argument (Protz) | Defendant's Argument (Derry Area SD) | Held |
|---|---|---|---|
| Whether Section 306(a.2) unlawfully delegates legislative power by requiring use of the "most recent" AMA Guides | The statute hands lawmaking authority to the AMA because later editions can change legal entitlement (who is >/<50% impaired) | Prior Commonwealth Court precedent upheld the provision or declined to decide delegation claims; statute is a permissible adoption of expert standards | The Court held the provision unconstitutional insofar as it proactively adopts post‑1996 editions without legislative or governmental review and guidance; remanded to apply the Fourth Edition |
| Whether delegation to a private body (AMA) is permissible absent standards or review | The AMA is a private entity with no public accountability; legislature failed to provide intelligible standards or a review mechanism | The process is medical and fact‑driven: physicians perform ratings; General Assembly provided guiding statutory criteria (who may rate, definitions, use of Guides) | The majority said delegation to a private body without standards or review is impermissible; dissent argued existing statutory safeguards and adjudicative processes suffice |
| Whether prior regulatory or judicial interpretations (e.g., grace periods, choice of edition) can salvage the statute | Argued statute is void as written regardless of agency rule | Employer pointed to Bureau regulation and cases (Stanish, Wingrove) upholding application or declining to reach constitutional challenge | Court rejected regulatory contravention (grace period) and held constitutional challenge meritorious on non‑delegation grounds |
| Remedy: Which edition governs pending remand | Protz argued statute cannot be applied prospectively to adopt later AMA changes without review | Employer argued existing practice and precedents support use of more recent Guides | Court directed use of the Fourth Edition (the edition in force when the statute was enacted) and remanded for application to the modification petition |
Key Cases Cited
- Holgote Brothers Co. v. Bashore, 200 A. 672 (Pa. 1938) (affirming that legislative power is vested solely in the General Assembly and cannot be delegated)
- Bell Telephone Co. of Pennsylvania v. Driscoll, 21 A.2d 912 (Pa. 1941) (invalidating delegation where statute provided no standards to guide agency discretion)
- Association of Settlement Companies v. Department of Banking, 977 A.2d 1257 (Pa. Cmwlth. 2009) (statute delegating to agency invalid where it lacked intelligible standards to regulate conduct)
- Pennsylvania Builders Ass'n v. Dep't of Labor & Industry, 4 A.3d 215 (Pa. Cmwlth. 2010) (en banc) (upholding delegation where statute provided definite and reasonable standards and required administrative review before adopting model codes)
- Stanish v. Workers' Comp. Appeal Bd. (James J. Anderson Constr. Co.), 11 A.3d 569 (Pa. Cmwlth. 2010) (interpreting statutory mandate that the "most recent" AMA Guides govern and rejecting a Bureau regulation that created a grace period)
- Wingrove v. Workers' Comp. Appeal Bd. (Allegheny Energy), 83 A.3d 270 (Pa. Cmwlth. 2014) (rejecting an undeveloped constitutional challenge to Section 306(a.2))
- Carter v. Carter Coal Co., 298 U.S. 238 (U.S. 1936) (striking delegation to private parties as an unconstitutional delegation under federal due process principles)