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PRIOR PRINTER'S NO. 2513
PRINTER'S NO. 3595
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1840
Session of
2017
INTRODUCED BY KAUFFMAN, EVERETT, PICKETT, BLOOM, ROTHMAN,
MILLARD, MACKENZIE, GREINER, TURZAI, COX, IRVIN, MAHER, RYAN,
WARD, WHEELAND, FEE, RADER, METCALFE, KEEFER, McGINNIS,
TOPPER, DELOZIER, MUSTIO, DUSH, NELSON, F. KELLER, SAYLOR,
PHILLIPS-HILL, KNOWLES AND GROVE, OCTOBER 2, 2017
AS REPORTED FROM COMMITTEE ON LABOR AND INDUSTRY, HOUSE OF
REPRESENTATIVES, AS AMENDED, JUNE 4, 2018
AN ACT
Amending the act of June 2, 1915 (P.L.736, No.338), entitled "An
act defining the liability of an employer to pay damages for
injuries received by an employe in the course of employment;
establishing an elective schedule of compensation; providing
procedure for the determination of liability and compensation
thereunder; and prescribing penalties," in liability and
compensation, further providing for schedule of compensation
and for physical examination or expert interview.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 306(a.2) of the act of June 2, 1915
(P.L.736, No.338), known as the Workers' Compensation Act, is
repealed and the section is amended by adding a clause to read:
Section 306. The following schedule of compensation is
hereby established:
* * *
[(a.2) (1) When an employe has received total disability
compensation pursuant to clause (a) for a period of one hundred
four weeks, unless otherwise agreed to, the employe shall be
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required to submit to a medical examination which shall be
requested by the insurer within sixty days upon the expiration
of the one hundred four weeks to determine the degree of
impairment due to the compensable injury, if any. The degree of
impairment shall be determined based upon an evaluation by a
physician who is licensed in this Commonwealth, who is certified
by an American Board of Medical Specialties approved board or
its osteopathic equivalent and who is active in clinical
practice for at least twenty hours per week, chosen by agreement
of the parties, or as designated by the department, pursuant to
the most recent edition of the American Medical Association
"Guides to the Evaluation of Permanent Impairment."
(2) If such determination results in an impairment rating
that meets a threshold impairment rating that is equal to or
greater than fifty per centum impairment under the most recent
edition of the American Medical Association "Guides to the
Evaluation of Permanent Impairment," the employe shall be
presumed to be totally disabled and shall continue to receive
total disability compensation benefits under clause (a). If such
determination results in an impairment rating less than fifty
per centum impairment under the most recent edition of the
American Medical Association "Guides to the Evaluation of
Permanent Impairment," the employe shall then receive partial
disability benefits under clause (b): Provided, however, That no
reduction shall be made until sixty days' notice of modification
is given.
(3) Unless otherwise adjudicated or agreed to based upon a
determination of earning power under clause (b)(2), the amount
of compensation shall not be affected as a result of the change
in disability status and shall remain the same. An insurer or
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employe may, at any time prior to or during the five hundred-
week period of partial disability, show that the employe's
earning power has changed.
(4) An employe may appeal the change to partial disability
at any time during the five hundred-week period of partial
disability; Provided, That there is a determination that the
employe meets the threshold impairment rating that is equal to
or greater than fifty per centum impairment under the most
recent edition of the American Medical Association "Guides to
the Evaluation of Permanent Impairment."
(5) Total disability shall continue until it is adjudicated
or agreed under clause (b) that total disability has ceased or
the employe's condition improves to an impairment rating that is
less than fifty per centum of the degree of impairment defined
under the most recent edition of the American Medical
Association "Guides to the Evaluation of Permanent Impairment."
(6) Upon request of the insurer, the employe shall submit to
an independent medical examination in accordance with the
provisions of section 314 to determine the status of impairment:
Provided, however, That for purposes of this clause, the employe
shall not be required to submit to more than two independent
medical examinations under this clause during a twelve-month
period.
(7) In no event shall the total number of weeks of partial
disability exceed five hundred weeks for any injury or
recurrence thereof, regardless of the changes in status in
disability that may occur. In no event shall the total number of
weeks of total disability exceed one hundred four weeks for any
employe who does not meet a threshold impairment rating that is
equal to or greater than fifty per centum impairment under the
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most recent edition of the American Medical Association "Guides
to the Evaluation of Permanent Impairment" for any injury or
recurrence thereof.
(8) (i) For purposes of this clause, the term "impairment"
shall mean an anatomic or functional abnormality or loss that
results from the compensable injury and is reasonably presumed
to be permanent.
(ii) For purposes of this clause, the term "impairment
rating" shall mean the percentage of permanent impairment of the
whole body resulting from the compensable injury. The percentage
rating for impairment under this clause shall represent only
that impairment that is the result of the compensable injury and
not for any preexisting work-related or nonwork-related
impairment.]
(a.3) (1) When an employe has received total disability
compensation pursuant to clause (a) for a period of one hundred
four weeks, unless otherwise agreed to, the employe shall be
required to submit to a medical examination which shall be
requested by the insurer within sixty days upon the expiration
of the one hundred four weeks to determine the degree of
impairment due to the compensable injury, if any. The degree of
impairment shall be determined based upon an evaluation by a
physician who is licensed in this Commonwealth, who is certified
by an American Board of Medical Specialties approved board or
its osteopathic equivalent and who is active in clinical
practice for at least twenty hours per week, chosen by agreement
of the parties, or as designated by the department, pursuant to
the sixth edition of the American Medical Association "Guides to
the Evaluation of Permanent Impairment." IMPAIRMENT," 6TH
EDITION (SECOND PRINTING APRIL 2009).
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(2) If such determination results in an impairment rating
that meets a threshold impairment rating that is equal to or
greater than fifty per centum impairment under the sixth edition
of the American Medical Association "Guides to the Evaluation of
Permanent Impairment," 6TH EDITION (SECOND PRINTING APRIL 2009),
the employe shall be presumed to be totally disabled and shall
continue to receive total disability compensation benefits under
clause (a). If such determination results in an impairment
rating less than fifty per centum impairment under the sixth
edition of the American Medical Association "Guides to the
Evaluation of Permanent Impairment," 6TH EDITION (SECOND
PRINTING APRIL 2009), the employe shall then receive partial
disability benefits under clause (b): Provided, however, That no
reduction shall be made until sixty days' notice of modification
is given.
(3) Unless otherwise adjudicated or agreed to based upon a
determination of earning power under clause (b)(2), the amount
of compensation shall not be affected as a result of the change
in disability status and shall remain the same. An insurer or
employe may, at any time prior to or during the five hundred-
week period of partial disability, show that the employe's
earning power has changed.
(4) An employe may appeal the change to partial disability
at any time during the five hundred-week period of partial
disability; Provided, That there is a determination that the
employe meets the threshold impairment rating that is equal to
or greater than fifty per centum impairment under the sixth
edition of the American Medical Association "Guides to the
Evaluation of Permanent Impairment." IMPAIRMENT," 6TH EDITION
(SECOND PRINTING APRIL 2009).
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(5) Total disability shall continue until it is adjudicated
or agreed under clause (b) that total disability has ceased or
the employe's condition improves to an impairment rating that is
less than fifty per centum of the degree of impairment defined
under the sixth edition of the American Medical Association
"Guides to the Evaluation of Permanent Impairment." IMPAIRMENT,"
6TH EDITION (SECOND PRINTING APRIL 2009).
(6) Upon request of the insurer, the employe shall submit to
an independent medical examination in accordance with the
provisions of section 314 to determine the status of impairment:
Provided, however, That for purposes of this clause, the employe
shall not be required to submit to more than two independent
medical examinations under this clause during a twelve-month
period.
(7) In no event shall the total number of weeks of partial
disability exceed five hundred weeks for any injury or
recurrence thereof, regardless of the changes in status in
disability that may occur. In no event shall the total number of
weeks of total disability exceed one hundred four weeks for any
employe who does not meet a threshold impairment rating that is
equal to or greater than fifty per centum impairment under the
sixth edition of the American Medical Association "Guides to the
Evaluation of Permanent Impairment" IMPAIRMENT," 6TH EDITION
(SECOND PRINTING APRIL 2009), for any injury or recurrence
thereof. In determining the number of weeks payable under this
section, the insurer shall be credited for all weeks paid prior
to the effective date of this section for the injury or
recurrence regardless of the date of the injury or recurrence.
(8) (i) For purposes of this clause, the term "impairment"
shall mean an anatomic or functional abnormality or loss that
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results from the compensable injury and is reasonably presumed
to be permanent.
(ii) For purposes of this clause, the term "impairment
rating" shall mean the percentage of permanent impairment of the
whole body resulting from the compensable injury. The percentage
rating for impairment under this clause shall represent only
that impairment that is the result of the compensable injury and
not for any preexisting work-related or nonwork-related
impairment.
* * *
Section 2. Section 314(b) of the act is amended to read:
Section 314. * * *
(b) In the case of a physical examination, the employe shall
be entitled to have a health care provider of his own selection,
to be paid by him, participate in such examination requested by
his employer or ordered by the workers' compensation judge. In
instances where an examination is requested in relation to
section [306(a.2)(1)] 306(a.3)(1), such examination shall be
performed by a physician who is licensed in this Commonwealth,
who is certified by an American Board of Medical Specialties
approved board or its osteopathic equivalent and who is in
active clinical practice for at least twenty (20) hours per
week.
SECTION 3. THE FOLLOWING SHALL APPLY:
(1) FOR THE PURPOSES OF DETERMINING WHETHER AN EMPLOYEE
SHALL SUBMIT TO A MEDICAL EXAMINATION TO DETERMINE THE DEGREE
OF IMPAIRMENT AND WHETHER AN EMPLOYEE HAS RECEIVED TOTAL
DISABILITY COMPENSATION FOR THE PERIOD OF 104 WEEKS UNDER
SECTION 306(A.3)(1) OF THE ACT, AN INSURER SHALL BE GIVEN
CREDIT FOR WEEKS OF TOTAL DISABILITY COMPENSATION PAID PRIOR
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TO THE EFFECTIVE DATE OF THIS PARAGRAPH. THIS SECTION SHALL
NOT BE CONSTRUED TO ALTER THE REQUIREMENTS OF SECTION
306(A.3) OF THE ACT.
(2) FOR THE PURPOSES OF DETERMINING THE TOTAL NUMBER OF
WEEKS OF PARTIAL DISABILITY COMPENSATION PAYABLE UNDER
SECTION 306(A.3)(7) OF THE ACT, AN INSURER SHALL BE GIVEN
CREDIT FOR WEEKS OF PARTIAL DISABILITY COMPENSATION PAID
PRIOR TO THE EFFECTIVE DATE OF THIS PARAGRAPH.
Section 3 4. This act shall take effect immediately.
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