*In June 2017, the PA Supreme Court in the Protz case declared IREs unconstitutional. However, the state legislature is looking to pass another similar law to get around the court’s ruling.
How long can I receive total disability workers’ compensation benefits? It’s a common question among injured workers in Pennsylvania. Broadly speaking, the answer is quite simple: there is no limit on the amount of time an injured worker may receive total disability benefits.
However, when it comes to seeking longer-term benefits for total disability, the devil’s in the details. Many workers’ compensation recipients face a substantial stumbling block in the form of an Impairment Rating Evaluation (“IRE”).
The Pennsylvania IRE Process
In Pennsylvania, after an individual has received total disability payments for 104 weeks, the workers’ compensation insurance company providing benefits can request him or her to attend an IRE. Although the term “request” is used in the Pennsylvania Code, injured workers functionally have no choice but to comply: failure to attend the IRE can result in the insurer attempting to suspend benefit payments.
At the IRE, a doctor selected by the Pennsylvania Bureau of Workers’ Compensation will examine the injured worker and thoroughly review his or her medical records. Then, based on American Medical Association guidelines, the doctor will express the workers’ level of impairment from their on-the-job injury in terms of a percentage (an individual with a 0 percent rating would face no difficulty in completing day to day activities, while someone who received a 50 percent or more rating would have significant trouble with commonplace tasks).
Effect of a Low IRE Rating
Any worker who receives an impairment rating of 50 percent or more is presumed to be totally disabled. But, if the examining physician determines an individual is less than 50 percent impaired by their work injury, the workers’ compensation insurer may be able to change their disability status from “total” to “partial.” This does not change the amount of benefits.
A partial disability designation has a devastating effect on the receipt of long-term workers’ compensation benefits. Although the amount of weekly workers’ compensation payments will remain the same for a worker whose disability status has been reduced to partial, benefits for partially disabled workers last for a maximum of 500 weeks (about nine and a half years).
Challenging Partial Disability Status
Receiving a low impairment rating is not necessarily the end of the road for injured workers: a downward adjustment of benefit status may be appealed.
Don’t let the full workers’ compensation benefits you deserve slip through your fingers. Whether your disability status has been downgraded to partial or you are concerned about an upcoming IRE, you can benefit from the services of an experienced Pennsylvania workers’ compensation lawyer. Contact an attorney today to explore your legal options.