Court Allows Work Stress PI Under 4th ed. AMA Guides

The Maine Supreme Court has just issued another decision confirming that psychological permanent impairment (PI) can be rated, but holding that it must be done under the 4th edition of the AMA Guides to the Evaluation of Permanent Impairment and not by reference to other sources.

In Smart v. Department of Public Safety, 2008 ME 172, the employee is a former state trooper who worked out of Fort Kent in Aroostook County. He claimed a mental stress injury under §201(3) which aggravated his pre-existing mental disorders, and in 1998 he was awarded ongoing 70% partial incapacity benefits.

Years later, the employer filed a Petition for Review to terminate his benefits at the end of the durational limit, and the employee claimed his psychological PI was above the threshold, making the durational limit inapplicable. Dr. Wear-Finkle performed a §312 IME and found 45% PI by referring to the 2nd edition of the AMA Guides, because she did not find the 4th edition very helpful. Hearing Officer Sprague adopted her opinion and denied the employer’s Petition for Review.

The employer appealed, arguing that the Board could not assign a numerical PI rating under the 4th edition of the AMA Guides. In its recent Harvey decision, the Court ruled that a percentage PI rating is permissible for a mental condition caused by a physical injury. In this case, the Court ruled that a percentage PI rating is also permissible for a mental stress injury, but it vacated the Board’s decision because the hearing officer adopted an IME opinion that was "inconsistent with the 4th edition of the AMA Guides."

In its Harvey and Smart decisions, the Law Court has made it clear that hearing officers are free to adopt psychological PI opinions rendered by treating or examining doctors and psychologists, as long as they are based on the AMA Guides 4th edition. The assignment of PI percentages for psychological conditions has questionable validity under the 4th edition, as Dr. Wear-Finkle pointed out in the Smart case. Disputes over psychological PI ratings will now be won or lost based on the parties’ success in persuading these experts to change their opinions on this issue.