With regard to injuries occurring on or after June 24, 1996, Section 306(a.2)(1) of the Workers’ Compensation Act enables a workers’ compensation insurance carrier to request an Impairment Rating Evaluation (“IRE”) when a Claimant has received one hundred four (104) weeks of total disability compensation. The Claimant is required to attend such an examination if requested. If a Claimant fails to attend the IRE, benefits could be suspended until the IRE is completed.
An IRE is an independent medical examination by a physician appointed by the Bureau of Workers’ Compensation. Based on the examination, the appointed physician determines the degree of impairment (impairment rating) caused by the Claimant’s work-related injury. The physician utilizes the American Medical Association’s “Guides to Evaluation of Permanent Impairment” in determining a Claimant’s rating. If that impairment rating is equal to or greater than fifty (50%) percent, the Claimant is presumed to be totally disabled and continues to receive total disability benefits. If the impairment rating is less than fifty (50%) percent, the Claimant’s status is changed to partial disability after receiving sixty (60) days notice of the modification. Although the IRE does not automatically change the amount of workers’ compensation benefits received (that must be done by establishing work is available to a claimant by a separate procedure), partial disability status does limit future benefits to 500 weeks.
If the IRE examination reveals that a Claimant continues to be totally disabled, by an impairment rating of 50% or more, the workers’ compensation insurance carrier may seek additional IRE’s. The workers’ compensation insurance carrier is permitted to request only two IRE’s during a twelve month period.
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