All you know is that you were hurt at work. Your employer accepted your claim as compensable. That is, your company agreed that your on-the-job injuries entitled you to workers’ compensation benefits. However, now there’s talk of an impairment rating evaluation. Understandably, you have no idea what that entails or what it means to you in the long run.
An impairment rating evaluation is also known by its acronym (IRE). The Commonwealth’s Department of Labor & Industry classifies IREs as part of health care services review. As such, they are medical evaluations conducted in select workers’ compensation cases.
Meanwhile, you should know that the Commonwealth recognizes different levels of impairment when it comes to work-related injuries. When you are unable to work because of an injury, you start by receiving temporary disability benefits.
Consider this. You are out of work on temporary disability for 104 weeks. In fact, your treating doctors have communicated with the workers’ compensation insurance company. They feel you’ve reached maximum medical benefit. In the meantime, there’s some indication that you’ve suffered some degree of permanent impairment.
In the meantime, you should know that there’s an assumption during the period of time you’re out on temporary disability. Although the hope is that you’ll be able to return to work, you’re considered on total disability – even it’s on a temporary basis.
104 weeks marks the point where you can expect to receive a request to undergo an IRE. The physician who examines you uses a rating scale in determining your physical loss of function.
IMPAIRMENT RATING EVALUATION: THE NUMBERS
The rating scale matters when it comes to determining how long you can continue to receive benefits. Impairments under 35% represent partial disability. In the case of partial disability, your payment period may not extend more than 500 weeks. Although the weekly amount you receive won’t change, the length of time will be affected.
You should know that new legislation changed some of the rules regarding IREs. Act 111 came as a result of a 2017 Supreme Court decision that questioned the constitutionality of impairment rating evaluations. In addition to when you will be required to submit to the IRE, here are some key parts of the new law:
- Insurer will request IRE within 60 days after 104 weeks expires
- Purpose of the exam is to determine the degree of impairment
- Physicians will use AMA’s Guide to the Evaluation of Permanent Impairments” to make rating determinations
- Ratings over 35% allow employees to continue receipt of total disability benefits
All things considered, the process could cause you grave concern as you worry about cessation of workers’ compensation benefits. You should absolutely speak with an experienced workers’ compensation attorney to discuss your concerns.
We Are Here to Help
If you suffered a work-related injury, we can help you. Contact Fellerman & Ciarimboli for experienced legal representation.