Have you been completely disabled from working due to a workplace injury in Harrisburg? If so, you may be receiving wage-loss benefits through Pennsylvania’s workers’ compensation program equivalent to two-thirds of your pre-accident earnings. Total disability benefits allow you to feed your family, pay your bills, and keep a roof over your head during a challenging time. Unfortunately, they’re also expensive for your employer’s insurance provider. As such, the company might insist that you complete an Impairment Rating Evaluation (IRE) to determine if you are still totally disabled and entitled to continued benefits.
The Pennsylvania workers’ comp attorneys at Calhoon & Kaminsky P.C. understand the importance of staying on total disability for as long as your injuries require it, and we’re ready to fight to protect that right. Our firm has focused exclusively on workers’ comp claims for over 20 years, and we’re proud of our loyalty to Pennsylvania workers. Contact us today for a free case review.
What is an Impairment Rating Evaluation (IRE)
What does IRE mean?
An Impairment Rating Evaluation, or IRE, is a medical examination that your employer’s insurance company requests to determine the extent of your disability following a workplace injury.
The insurance company doesn’t request an IRE out of mere curiosity. They want to save money on disability payments, and they request an IRE to get information that may allow them to reduce your payments. If the examining doctor determines you no longer qualify for a total disability following the IRE, Pennsylvania workers’ compensation will reduce your benefits.
When Does an IRE Need to Be Conducted?
An insurance company cannot request an IRE until you receive total disability benefits for 104 weeks. You’re not required to submit to an IRE until you’ve received benefits for that length of time.
The insurance company does have an incentive to request an IRE as soon as possible following the 104-week mark, though. Suppose they submit the request within 60 days of that date, and the doctor reduces your workman’s comp impairment rating. In that case, your change in status from total to partial disability will be automatically granted. If they submit the request more than 60 days after the 104-week date, they must petition for any change to your disability status.
Insurers can request that you submit up to two IREs during a 12-month period, regardless of whether there’s been any change in your condition. They aren’t allowed to request more than two IREs per year.
What Happens During An IRE?
The IRE process begins with the insurer sending you a notice requesting that you submit to a medical examination by a specific doctor at a prescheduled time, date, and location. If you’ve already retained the services of a Pennsylvania workers’ compensation attorney, you should inform them of your receipt of this notice and seek their counsel. If you don’t have a lawyer, you should consider contacting one at this time.
During the examination, the doctor will evaluate you using standards set by the American Medical Association. They’ll be looking specifically at your level of impairment to determine your overall condition. The exam will consist of questions and tests of your abilities, including your ability to move your limbs, lift objects, balance, and more.
Following the examination, the doctor will complete an impairment rating report and assign a percentage to your level of impairment. Under Pennsylvania law, if your impairment rating is 35 percent or higher, you are eligible for total disability benefits. If your impairment rating is below 35 percent, your status will likely be adjusted to partially disabled, and your benefits will be reduced accordingly. You may appeal this decision to a workers’ comp judge.
What to Do and What Not to Do During an IRE
Your IRE is important and can result in changes to your workers’ compensation case, so it’s helpful to understand what to do – and what not to do – during the exam.
For starters, don’t go alone. Have a friend or family member join you. They can take notes and also give the doctor some added incentive to conduct a fair evaluation of your condition. If you can take some notes yourself, you should do so. After the IRE, compare these notes with your companion’s notes to ensure you have an accurate record.
It’s also important to be honest during the exam when the doctor asks about your symptoms, capabilities, and experience. Be accurate in your descriptions, but also stick to the subject at hand – avoid tangents and making small talk, and focus on being as precise and honest as possible.
Finally, you can ask what the doctor plans to say in their write-up. This isn’t secret information, and asking about it allows you to clarify misunderstandings and correct errors.
Can an IRE Affect Your Workers’ Compensation Case?
The results of an IRE can affect your workers’ compensation case by limiting the time you can receive total disability benefits. With an impairment rating of less than 35 percent and a status of partially disabled, you may be required to return to work in a reduced capacity. You can receive two-thirds of the difference between your pre- and post-injury wages, but you’re limited to 500 weeks of these benefits. Total disability benefits, on the other hand, last for as long as you cannot return to work.
What Can a Pennsylvania Workers’ Compensation Attorney Do For You?
A Pennsylvania workers’ compensation lawyer is a critical ally if your employer’s insurer tries to end your total disability benefits. They can help you challenge an impairment rating by producing supporting evidence of your own and representing you at subsequent hearings. Beyond this, they can explain the system to you so that you understand your options and are able to make informed decisions about your future.
Contact our Harrisburg Workers’ Compensation Lawyers Today
Calhoon and Kaminsky P.C. takes pride in assisting Pennsylvania workers who have been hurt on the job and need help securing the benefits they deserve. We help workers and their families move forward from devastating, debilitating injuries and look toward the future.
You can trust us to fight for the workers’ compensation benefits you deserve under Pennsylvania law. We’re happy to meet with you in our Harrisburg office, at your home, at another convenient location. Our goal is to make the legal process transparent and hassle-free, and you only pay legal fees if we secure compensation for you. Contact us today for your free case review.
