A worker who has suffered a serious injury at work, has missed work while they are recovering from their injury, and is receiving workers’ compensation partial wage-replacement disability benefits. The workers’ compensation insurer must determine whether the worker will be able to return to their previous job, whether they will can do some other type of work, or whether they will be permanently disabled.
However, there is often some degree of controversy about the final impairment rating. The employee may not feel able to return to his or her job while the employer’s insurer assures them that they are healthy enough to return to work and that they no longer qualify for disability benefits.
Who is correct: the employee or the employer’s workers’ compensation insurer’s physician?
Determining an injured worker’s impairment
An impairment can be physical or mental. It has an impact on the individual’s ability or inability to perform their work functions and activities of daily living, but it also has an impact on the employee’s benefits. If a worker has a permanent impairment, they will receive more benefits for a longer time.
The impairment Rating Evaluation (IRE)
The controversy arises when the insurer’s doctor gives the worker an impairment rating that benefits the insurer, who is paying their salary. An Impairment Rating Evaluation (IRE) is conducted by an independent medical professional who rates the patient’s level of impairment between 0 and 100. This rating determines how much the injured worker might receive in benefits, how long they can receive them and whether they will be able to return to work.
In June of 2017, the Pennsylvania Supreme Court ruled that it was unconstitutional to modify or limit someone’s benefits because of an IRE score. However, the IRE can still be used to determine whether or not you are granted benefits to begin with.
If you do not agree with the impairment rating that the insurer’s medical provider has assigned to you, you can dispute it. If you can show that your degree of impairment is greater that the insurance company doctor has assessed, you may be successful in appealing the ruling. You will require the services of an experienced Philadelphia workers’ compensation lawyer to represent you in your dispute with the workers’ compensation insurance company.
When you work with Larry Pitt & Associates, you work with attorneys who know how to fight for your rights. Please call 1.888. PITT.LAW or fill out our contact form to set up a no-obligation consultation with a dedicated Philadelphia workers’ compensation attorney today. We proudly serve Berks, Bucks, Chester, Delaware, Montgomery and Philadelphia Counties.
