Impairment Rating Evaluations

Since the 1996 changes to the Act, Employers have had the benefit of sending claimants to Impairment Rating Evaluations to try and reduce their wage loss benefits. Namely, a doctor uses American Medical Association (AMA) guides to assign a percentage score to a person’s disability. If one gets less than 50%, wage loss benefits are limited to 500 weeks.

Unfortunately, the Impairment Rating process does not even try to “make an injured worker whole”. While about 37 states now use these AMA guides in some form, Pennsylvania differs in the excessively high percentage needed to get reliable ongoing benefits. A 50+% rating is very, very rare. Our Workers’ Compensation attorneys can collectively count on one hand the number of clients who have actually met this standard since 1996. And keep in mind that most of our clients have serious disabilities. In short, the threshold for a finding of total disability is too high.

The second problem that needs to be addressed is the 500 week limitation. That’s less than ten years. Consider a worker who has a serious neck injury in her twenties. Her disability prevents her from ever going back to work as, say, a nurse’s assistant. Let’s say she never finds a job that she can physically do, or never finds a job that pays as well as her pre-injury position? The Act says she no longer gets compensation, despite her disability.

We maintain that the legislature needs to revise the IRE provisions of the Act. First, consider a lower threshold. Many states use 25% as their cutoff rating. Next, consider extending the period in which wage loss benefits are payable. Some states allow for 700 weeks when the claimant is not totally disabled.

The pendulum has swung too far in the employers’ favor. It’s time for the Act to evolve and once again.

Next week: reeducation.

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