Most people never think much about how the workers’ compensation determinations are guided. What standards are doctors and worker’s compensation insurance providers supposed to use when making health-care recommendations or benefits determinations?
In Pennsylvania, the law states that the most recent edition of the American Medical Association (AMA) guidelines are to be used for determining impairment ratings of injured workers seeking benefits. However, due to a current case being heard by the Pennsylvania Supreme Court, this law could be changing soon.
How Much Power Should A Private Entity Have?
According to a recent article in The Legal Intelligencer, a Pennsylvania worker’s compensation case is being argued involving the validity of the law citing the AMA’s most recent recommendations as the authoritative criteria for workers’ compensation determinations.
It’s something that most people would never think of: If the workers’ compensation program is supposed to use the recommendations of the American Medical Association (AMA), isn’t this way too much power for a private entity? People’s well-being hangs in the balance, judges need to follow the laws and all of the direction is coming from a private entity, the AMA.
To further complicate the issue, another problem brought up in the case is that the legislature has provided no guidelines or public policy considerations to guide the AMA in its creation of medical guidelines. If the AMA has no idea what the legislature has as its primary goals and concerns, it is much more likely the AMA will create guidelines that just don’t match up with a successful workers’ compensation schema.
Whether or not you think the workers’ compensation program in Pennsylvania is working successfully, it is clear that there is still a lot to work out to make the law clear on these issues. If you or someone you love has been seriously hurt at work, it is critical to work with an attorney who understands the changing workers’ compensation laws and can get you the help you need.