The Protz case briefly eliminated Impairment Rating Evaluations from the Pennsylvania workers compensation lexicon. After HB 1840 was signed into law by Governor Wolf, the IRE has returned!
Under the Pennsylvania Workers’ Compensation Act, an Impairment Rating Evaluation (IRE) is a procedure whereby a state-appointed physician assesses an injured worker’s impairment, It is entirely unrelated to the treatment of a work-related medical condition. Instead, it is a mechanism that allows employers and their insurance carriers to estimate their total long-term financial costs related to the payment of wage-loss benefits for a work-related injury or medical condition.
At the point in time that an injured worker has received 104 weeks of total disability compensation, an employer may request an IRE to determine the worker’s whole-body impairment. This request is handled by a designated physician, who considers whether an injured worker has achieved maximum medical improvement.
Unless the parties agree, a request for an Impairment Rating Evaluation before the expiration of the 104-week period is not permitted by the Act. However, this presumption of total disability may be challenged at any time by a demonstration of earning power under the Act.
As a result of recent amendments, if the result of an IRE is a rating is 35% or higher, a worker will be presumed to be totally disabled and may continue to receive total disability benefits. However, if the evaluation results in an impairment rating below 35% and the IRE request was filed within 60 days of the 104th week that disability benefits were paid, the worker’s disability status converts from total disability to partial disability for 500 weeks.
However, if the IRE request is made more than 60 days after the 104th week, the employer must file a petition to modify status. This specific procedure is different than the procedure for handling those requests during the initial 60-day window and which are thereby considered timely. More importantly, this also results in more difficulty in modifying benefits.
Typically, the only medical evidence presented is the treating physician’s report. Thus, in the absence of conflicting medical evidence, the IRE petition is granted. Many injured workers failed to reach the former threshold of 50% despite having permanent injuries and lost benefits after 500 weeks because of the IRE. It will be interesting to see the results now that the state legislature has lowered this threshold to 35%.
Experienced legal counsel may help applicants filing a claim under Pennsylvania law. Powell Law’s unsurpassed qualifications make it an obvious choice for representation in workers’ compensation cases in the Scranton/Wilkes-Barre area. Applicants for workers’ compensation benefits require the assistance of an experienced workers’ compensation attorney. Contact Powell Law at (570) 961-0777. The consultation is FREE and you don’t pay unless we win!