With regard to injuries occurring on or after June 24, 1996, Section 306(a.2)(1) of the Workers’ Compensation Act enables a workers’ compensation insurance carrier to request an Impairment Rating Evaluation (“IRE”) when a Claimant has received one hundred four (104) weeks of total disability compensation. The Claimant is required to attend such an examination if requested. If a Claimant fails to attend the IRE, benefits could be suspended until the IRE is completed.
An IRE is an independent medical examination by a physician appointed by the Bureau of Workers’ Compensation. Based on the examination, the appointed physician determines the degree of impairment (impairment rating) caused by the Claimant’s work-related injury. The physician utilizes the American Medical Association’s “Guides to Evaluation of Permanent Impairment” in determining a Claimant’s rating. If that impairment rating is equal to or greater than fifty (50%) percent, the Claimant is presumed to be totally disabled and continues to receive total disability benefits. If the impairment rating is less than fifty (50%) percent, the Claimant’s status is changed to partial disability after receiving sixty (60) days notice of the modification. Although the IRE does not automatically change the amount of workers; compensation benefits received (that must be done by establishing work is available to a claimant by a separate procedure), partial disability status does limit future benefits to 500 weeks.
If the IRE examination reveals that a Claimant continues to be totally disabled, by an impairment rating of 50% or more, the workers’ compensation insurance carrier may seek additional IRE’s. The workers’ compensation insurance carrier is permitted to request only two IRE’s during a twelve month period.