When you are receiving permanent total disability benefits from your workers’ compensation program, you might have to undergo an Impairment Rating Evaluation (IRE). These evaluations are medical exams an employer uses to determine how long you can continue receiving disability through the workers’ compensation program.
If your employer has requested an IRE, it is important to fulfill the legal requirements involved in this process to receive fair benefits. A permanent disability attorney could walk you through how the physician conducts an assessment of impairment ratings in Philadelphia and what it could mean for your future. Gross & Kenny, LLP represents workers in Philadelphia, South Philly, and Bustleton.
When an employee experiences a work-related injury or develops a health problem due to their working conditions, workers’ compensation provides coverage during their recovery. A treating physician will eventually certify the worker has reached a state of maximum medical improvement (MMI), which means further treatment will have no measurable impact on the worker’s condition.
If the worker has reached MMI, but their condition does not allow them to resume their former job, they are entitled to permanent disability payments. Workers can receive up to 500 weeks of payments if their disability is partial. If their disability is total, a worker could receive payments for life.
An impairment rating is a way for a doctor to express how much an injury, illness, or condition interferes with a worker’s ability to perform their job. In Philadelphia, impairment rating assessments are expressed as a percentage between one and 100. Workers’ compensation considers an impairment rating of 35 percent or more as total disability, which may entitle the worker to lifetime payments.
An employer can request an Impairment Rating Evaluation after a worker has received 104 weeks of permanent disability payments. A doctor conducts a physical examination and tests how the injury or condition impacts the worker’s ability to perform specific tasks.
After the exam is complete, the doctor provides a copy of the medical evaluation and impairment rating form to the employer, their workers’ compensation insurer, and the worker. If the IRE asserts an impairment rating of less than 35 percent, the worker is no longer entitled to lifelong disability but will continue to receive partial disability payments for the duration of their coverage.
If the employer requested an IRE less than 60 days after the 104th week the worker received permanent disability payments, the change in status from permanent total disability to permanent partial disability happens automatically. If the employer requested the IRE more than 60 days after the 104th week, the employer must file a Petition seeking to change the employee’s status.
A Philadelphia worker who disagrees with the results of an assessment of impairment ratings does not have to accept the outcome. According to 77 Pennsylvania Statute § 511.3, an employee could contest their impairment rating during the time they continue to collect permanent partial disability payments.
With the help of a legal professional, a worker could challenge the IRE results by filing a Petition of Review. A workers’ compensation judge may review the evidence and decide whether to affirm or deny the worker’s disability status change. A worker unhappy with the judge’s decision could bring a further appeal to the Workers’ Compensation Appeals Board.
Insurance companies typically do not want to pay permanent disability benefits for longer than they are required to. For this reason, an employer and their insurance company may use the IRE as a tool to try and change a worker’s disability status.
Any worker in Philadelphia, South Philly, or Bustleton whose status has changed from permanent total disability to permanent partial disability because of an IRE should consult a capable lawyer as soon as possible. A legal professional could make the case to reinstate the worker’s permanent total disability payments. Call Gross & Kenny, LLP to learn more about assessments of impairment ratings in Philadelphia.
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