Westmoreland Regional Hospital v. Workers' Compensation Appeal Board
29 A.3d 120
Pa. Commw. Ct.2011Background
- Claimant Linda Pickford sustained work injuries from a bed collapse in 1997; initial NCP described cervical and lumbar sprains.
- Employer sought to terminate or modify benefits after an independent medical examination (IRE) yielded 22% total body impairment.
- The IRE was performed by Dr. Klein on September 27, 2006 under Section 306(a.2) of the Act.
- The IRE attributed 22% to the body but assigned zero impairment to RSD and to brachial plexus stretch due to lack of objective findings on the day of the examination.
- WCJ denied modification relying on Dr. Navarro’s later evidence of RSD; Board affirmed; the court reversed, holding the IRE’s validity is governed by the claimant’s condition on the date of the IRE and Barrett and Diehl controls.
- The court held that, because the IRE showed total impairment below 50%, Claimant’s disability status could change from total to partial as of the IRE date (Sept. 27, 2006).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether an IRE with zero ratings for some injuries invalidates the rating | Klein’s IRE properly rated injuries he could assess; zero ratings for RSD and brachial plexus were permissible. | Board invalidated the IRE by treating zero ratings as rejection of injuries. | No; Barrett allows zero ratings where no objective evidence exists. |
| Whether the IRE must rate every work injury to be valid | Impairment is determined on the day of the IRE; not all conditions must be rated if none shows objective signs. | Failure to rate all injuries renders the IRE invalid. | No; Barrett permits zero ratings for unproved injuries; IRE valid. |
| Whether the IRE date controls the impairment determination | Navarro’s later findings do not negate the IRE's date-based snapshot. | Subsequent records could affect impairment assessment. | Yes; impairment is based on the date of the IRE. |
| Role of the WCJ’s credibility findings in IRE challenges | WCJ credibility findings are not dispositive if the IRE is otherwise valid. | Diehl requires treating the IRE as evidence subject to credibility findings. | WCJ credibility findings govern the weight of the IRE testimony. |
| Effect of IRE impairment <50% on modification eligibility | IRE results justify changing from total to partial. | Modification requires credible support for impairment in excess of 50% evidence. | Correct; impairment <50% permits modification of status to partial. |
Key Cases Cited
- Barrett v. Workers’ Compensation Appeal Board (Sunoco, Inc.), 987 A.2d 1280 (Pa. Cmwlth. 2010) (an IRE with zero rating for a work injury is not invalid per se; objective evidence governs ratings)
- Diehl v. Workers’ Compensation Appeal Board (I.A. Construction), 607 Pa. 254 (2010) (IRE treated as evidence; WCJ credibility findings control modification outcome)
- Gardner v. Workers’ Compensation Appeal Board (Genesis Health Ventures), 585 Pa. 366 (2005) (automatic modification for timely IRE; concept of traditional administrative process)
- Ford Motor/Visteon Systems v. Workers’ Compensation Appeal Board (Gerlach), 970 A.2d 517 (Pa. Cmwlth. 2009) (IRE date controls disability status change; snapshot of condition at evaluation)