OK Supreme Court Rules On AMA Guide; PPD

Oklahoma City, OK (WorkersCompensation.com) – The Oklahoma Supreme Court ruled in a 5-4 opinion Wednesday that the latest edition of the AMA Guide should determine the parameters of permanent partial disability.

The decision, which stemmed from Robert Hill v. American Medical Response, approves the legislature’s mandate that determinations should come from the AMA Guides to Evaluation of Permanent Impairment, Sixth Edition, and rejected arguments that mandatory use of the latest edition of the guide violates the Oklahoma constitutional guarantee of due process, equal protection and access to a remedy.

In September 2014 while working as a paramedic with Respondent American Medical Response, Hill filed a workers’ compensation claim after suffering an injury to his shoulder. In a hearing about permanent partial disability, Hill challenged the report by his employer’s evaluating physician and whether or not the report was admissible in regards to the extent of his impairment. Hill also challenged the constitutionality of several provisions of the workers’ compensation statues requiring the use of the AMA, 6th edition.

Hill’s physician, Dr. Stephen Wilson, reported that Hill sustained an 8 percent whole person impairment if judged by the AMA Guides, Sixth Edition, and a 31.8 percent impairment if using the AMA Guides, Fifth Edition. American Medical’s physician, Dr. William Gillock, reported that Hill sustained a 4.2 percent whole person impairment if using the AMA guides, 6th Edition.

The administrative law judge rejected Hill’s claims, and determined Hill sustained a 7 percent whole person impairment, entitling him to an award of $7,913.50. Hill appealed to the Workers’ Compensation Commission who also rejected his claim, and then took his appeal to the Supreme Court.

According to the as yet unpublished decision, “The ALJ did not err by allowing the report of Employer's physician, Dr. Gillock, into evidence. The mandatory use of the AMA Guides, Sixth Edition, for assessing impairment for non-scheduled members does not violate the Constitution. The significant discrepancy of $28,035.50 in the dollar award for the disability resulting from Mr. Hill's job-related injury using the AMA Guides, Fifth Edition and the dollar award for the same disability under the AMA Guides, Sixth Edition is a direct consequence of the Legislature's adoption of the AMA Guides, Sixth Edition. Hill's claims concerning the ongoing destruction of the grand bargain and the increasing insufficiency of workers' compensation awards are arguments about policy best brought before the Oklahoma Legislature.”

Bob Burke, an Oklahoma attorney, said the decision was one that was eagerly awaited throughout the state.

"The decision was a blow for the state's injured workers. The 6th edition cuts most spine PPD percentages in half. The Chief Justice, writing for the 5-4 majority, recognized that the 6th edition shortchanges injured workers, a difference of $28,000 in this case, when the 6th is compared to the 5th edition. He also said it is clear that the Grand Bargain has been diminished for workers... On behalf of injured workers, we will ask the new Legislature next year to give some relief on the 6th edition issue, and to raise PPD benefits, which are now among the lowest in the nation,” Burke said in an email interview with WorkersCompensation.com. “The workers' comp world has been waiting on this decision for the 4 and a half years since the new comp law took effect. There are hundreds of cases pending.....that can now move forward.”

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