After an accident occurs, a worker’s ability to function can be compromised by injuries. This impairment can be partial, total, temporary or permanent. Workers who suffer these on-the-job injuries may have their Workers’ Compensation benefits determined by an impairment rating evaluation (IRE).
In June of 2017, the State Supreme Court proclaimed that certain provisions of the Workers’ Compensation Act pertaining to IREs were unconstitutional. It was ruled that employers and their insurers could not limit their responsibility to pay benefits by changing a worker’s disability status based on an IRE administered according to American Medical Association (AMA) guidelines. This ruling was beneficial for employees.
Pennsylvania IRE laws have recently changed. Insurers opposed the 2017 decision, and on October 24, 2018, the AMA IRE aspect of the Pennsylvania Workers’ Compensation Act was reinstated when Governor Wolf signed Act 111 (formerly HB 1840).
In most cases, a medical impairment rating is carried out by an independent medical professional during an IRE. These are performed after the employee has gotten 104 weeks of benefits following a work injury. To qualify for an IRE, the impairment has to be deemed permanent, and the employee has to have achieved as much medical improvement as possible. To classify as a permanent impairment, the examining physician must deem it to be stable and not likely to change.
A rating scale of zero to 100 percent is applied, and is used to calculate the benefits, as well as if that employee should return to work.
Act 111 stipulates that the 6th edition of AMA Guides to the Evaluation of Permanent Impairment be used when performing Pennsylvania IREs. In addition, total disability is assumed to remain when the impairment rating is equal to or greater than 35 percent. Previously, the percentage was 50 percent.
There are also procedures in place to limit the weeks that a worker qualifies for Workers’ Compensation, and more straightforward mechanisms for revising a status from total to partial disability.
While employers and insurers applaud this change, employees and their legal representatives are concerned that this will lead to more claim denials, and make retaining needed Workers’ Compensation benefits increasingly difficult.
If you need help with a Workers’ Compensation benefits claim, call a knowledgeable Pittsburgh work injury lawyer at AlpernSchubert P.C. We will work diligently to obtain the compensation you deserve. Our office is in Pittsburgh, and we represent clients in Allegheny County, Lawrence County, Washington County, and Western Pennsylvania. To schedule a free consultation, complete our online contact form or call us at 412-765-1888 or 800-243-6095.