Workers' Compensation: AMA Guidelines

The 2011 reforms added the use of AMA Guidelines as one of five factors in determining permanent partial disability (PPD) awards. The AMA Guidelines are more conservative in determining the awards and thus it was hoped that allowing Commissioners to use these guidelines would reduce awards. While

complete data on the use of AMA guidelines since 2011 is not yet available, a study of 20 cases from the IWCC shows a 12.24% reduction in awards when using the AMA guidelines. Indiana requires mandatory use of the AMA guidelines when determining permanent partial impairment which results in lower permanency awards.

Proposal

  • The language that limits the Commission from using only one of the five factors to determine PPD should be eliminated. This will allow (though not mandate) a Commissioner to solely base an award on the AMA guidelines.
  • The language that limits a Commissioner to only considering a treating physician’s medical records should also be eliminated. Instead, the Commission should be able to review both a treating physician’s and an independent medical examiner’s records to provide a more balanced view of the medical condition.

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