What is an Impairment Rating Evaluation (IRE)?
If you are receiving Pa. workersā compensation benefits, your employer or its insurance company may require you to attend a medical examination with a doctor of its own choosing. One type of special medical examination is known as an Impairment Rating Evaluation (IRE), which can be requested up to two times within a 12 month period after youāve been receiving benefits for 104. This exam is similar to an Independent Medical Examination, but its purpose is to try and limit your workersā compensation benefits.
What happens during an IRE?
During an IRE, a doctor applies the American Medical Associationās (AMA) guidelines to determine if the injured worker is more than 35 percent disabled. If the doctor concludes that the worker is less than 35 percent disabled, then the injured workerās benefits are capped at 500 weeks.
Recent updates to the law.
Doctors had been using the current 6th edition of the AMAās guidelines for evaluation, based on the lawās directive that they use the āmost recent editionā of those guidelines. A recent court case determined that use of the āmost recent editionā is unconstitutional because the guidelines were developed by a private company (the AMA) and not by a state agency, and because the guidelines havenāt been reviewed in nearly two decades. It is a violation of the constitution to give a private company the authority to determine how injured workers are evaluated under the law with no government oversight.
A new law passed in response to the decision changed the language, specifying that doctors must use the 6th edition of the AMAās guidelines. This would require that any changes to the guidelines must receive lawmaker approval. The new law also reduced the threshold for Total Disability Benefits from 50 percent to 35 percent.