Pittsburgh Post-Gazette

Wolf signs law meant to help employers limit comp costs

- By Daniel Moore Daniel Moore: dmoore@post-gazette.com, 412-263-2743 and Twitter @PGdanielmo­ore

Workers receiving compensati­on for some of the most grave onthe-job injuries again will have to undergo a follow-up medical examinatio­n that could result in a reduction of benefits — a provision in state law that the Pennsylvan­ia Supreme Court struck down last year.

This week, Gov. Tom Wolf signed into law a Republican-drafted bill reinstatin­g follow-up exams for the most severely injured workers — a bill that, lawmakers said, corrects issues the court ruled unconstitu­tional in June 2017.

Business groups had pushed for the measure, which was introduced in the Pennsylvan­ia House last fall, citing workers’ compensati­on insurance rates expected to sharply rise. After the ruling, annual benefits costs shot up 6 percent, which was the highest annual hike in at least 20 years and translated to double-digit increases in insurance premiums that employers pay.

Opponents of the new measure argued that the exams — called impairment rating evaluation­s — are another hurdle for workers that gives insurers wider latitude to limit benefits.

The number of employees affected by the debate are small in number but have injuries that weigh heavily in discussion of workers’ compensati­on’s costs and benefits.

Under the new law, an employer’s insurance provider can request that injured workers undergo a medical assessment after two years out of the workplace because of an injury.

If the physician finds that a worker was less than 35 percent injured at that point, the insurer can cap partial benefits at 10 years. If the physician rates a worker’s injury at more than 35 percent, the worker can receive full, lifetime benefits.

Those benefits are still not guaranteed, as the employer and insurer have other means to limit how long an injured worker receives them.

The case that successful­ly challenged the exams last year came from a 54-year-old Westmorela­nd County woman who badly hurt her knee when she slipped and fell at work 10 years ago.

The Pennsylvan­ia Supreme Court agreed with her Pittsburgh­based attorney, Thomas C. Baumann, that the state’s reliance on American Medical Associatio­n guidelines in those evaluation­s was an unconstitu­tional delegation of state power to a private group to determine taxpayer-funded benefits.

Mr. Baumann called the ruling “the most significan­t workers’ compensati­on ruling in Pennsylvan­ia in the past 30 years” that could “open the door for thousands of severely injured workers to receive benefits more accurately aligned with the extent of their injuries.”

Mr. Baumann could not be reached for comment on Friday.

The court’s ruling also roiled insurance markets, resulting in an unusual mid-year increase in benefit costs — a major component in the calculatio­n of workers’ compensati­on insurance premiums paid by businesses. Rep. Rob Kauffman, RFranklin, said that amounted to an annual increase of $165 million for businesses statewide.

Mr. Kauffman introduced the bill, HB 1840, last October to reinstate the evaluation­s. It passed in June by a 115-80 vote, and it was passed by the Senate last week by a 34-15 vote. Gov. Wolf signed the bill on Wednesday.

“With this legislativ­e fix, members of the House and Senate helped assure stability and fairness in the system and control workers’ comp costs for employers,” said Rebecca Oyler, state legislativ­e director of National Federation of Independen­t Businesses, in a statement.

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Getty Images/iStockphot­o Safety helmets and gloves hang from a rack at a mining site.

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