What is an Impairment Rating Evaluation?
If you or your loved one have been injured at work and are seeking workers’ compensation, you may be required to undergo an impairment rating evaluation to determine the extent of whole-body impairment caused by the workplace injury.
When an employer or insurance company requests an Impairment Rating Evaluation (IRE), it is to evaluate the total or partial disability of the injured worker so as to ensure the appropriate amount of disability pay is provided. Currently, Pennsylvania law requires an employer to pay total disability benefits for any employee at or above 35 percent disabled.
Unfortunately, many times an employer requesting an IRE is looking to reduce the number of benefits they are paying out by getting an evaluation that reports less than 35 percent disabled.
It is important that you or your loved one consult with an experienced workers’ compensation lawyer if you receive a notice for an impairment rating evaluation. You need to know your rights and the process so that you continue to receive the compensation and benefits you are entitled to. Our workers’ compensation lawyers can help you navigate the process.
Not every injury results in total disability compensation, but if your workplace injury has left you with impairment and disability, you will want to be aware of how an impairment rating evaluation works and what your rights are regarding fair compensation.
How Does an Impairment Rating Evaluation Work?
If you have been completely disabled due to a workplace injury, you are entitled to benefits for life, unless you recover enough to feel that you can return to work. However, after 104 weeks on full disability benefits, your employer and/or its insurance company can request that you take an impairment rating evaluation. If you do not attend a scheduled IRE appointment, you risk losing your benefits entirely.
Once you have passed the 104-week point of total disability benefits, your employer may request up to two IREs within a 12-month period. You are not required to submit to an IRE before the 104-week point in your benefits, nor are you required to submit to more than two IREs in a 12-month period after the 104 weeks have passed.
At your appointment, the doctor will assess your impairment and/or disability and assign a percentage of whole-body disability or impairment, accounting for the work-related injury. If the rating remains above 35 percent, you will continue to receive full disability benefits. If the rating is below 35 percent, your employer will most likely send you a notice of change in disability status, reducing the number of benefits they pay you each month.
If you receive this notice of change in status, you have the option to file a petition to review and appeal the change. You have 500 weeks to file this petition, in accordance with the 500-week timeline that you will continue to receive partial disability benefits.
It is important to note that an IRE can only be ordered once you have reached the point of maximum medical improvement, meaning the effects of your injury have stabilized and it is unlikely that you will see any substantial improvement throughout the next year, regardless of medical treatment. Even if the 104-week point has been passed, if you are still being treated and are seeing medical improvement, you are not required to submit to an IRE.
What Happens During an Impairment Rating Evaluation?
As with all potential legal issues, when you attend your IRE appointment, it is important that you speak honestly about your injuries without either exaggerating or downplaying them. You do not have to give more information than is necessary to answer the doctor’s questions, but you will want to be as specific as possible about your pain levels, the ways your impairment or disability affects you and your family, and how it challenges your day-to-day routines.
A doctor may feel inclined to put a positive spin on an evaluation or may interpret vague answers as recovery. The more specifically and accurately you can describe the impact of your injury, the less likely you will end up with an IRE that incorrectly rates your impairment or disability.
Additionally, you are allowed to ask to see what the doctor intends to submit in their evaluation. Asking to see their notes beforehand can allow you to clear up any confusion or misinterpretations that may occur during the appointment.
If possible, have a trusted companion attend your IRE appointment with you to make notes on your behalf about the doctor’s thoroughness and how the appointment went. If you are not able to take someone with you, do your best to make these notes yourself. They may be essential if you need to legally appeal a change in benefits due to a change of impairment rating.
How Do You Choose an Impairment Rating Evaluation Lawyer?
In a perfect world, you would be able to trust that your employer and/or its insurance company will pay you fair compensation for your work-related injury and that they will pay for as long as is appropriate. Unfortunately, too many employers and insurance companies are more interested in saving money than caring for their injured employees. This is why you should consult with an experienced Pennsylvania workers’ compensation lawyer as soon as you know you must file a workers’ compensation claim.
Navigating the claim process can be difficult, especially with employers looking to deny as many claims as possible. When your claim involves total disability payments, it is most likely that your employer will take the first chance they can to cut your benefits back to partial disability, or end your benefits altogether if they can.
When it comes to choosing a workers’ compensation lawyer to help you navigate your claim and an IRE, you want to look for a law firm with a track record of success with these very legal issues. Munley Law’s Pennsylvania workers’ compensation lawyers are the best in the Commonwealth. Our partners have been named to the Best Lawyers in America list for the last 30 years. Our lawyers are consistently recognized as the best in the business, ready and able to take on your personal injury claim and recover the compensation you deserve.
We have law offices throughout Pennsylvania, including Wilkes-Barre, Scranton, and Philadelphia. We also work on a contingency fee basis, meaning we don’t collect any fees until we’ve made a recovery in your favor. You can schedule a free consultation with our workers’ compensation lawyers either online or by phone. Someone is available to take your call 24/7.
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Posted in Workers' Compensation.