IRE Valid in PA Workers’ Comp Even if Condition is Later Objectively Worse

Impairment Rating Evaluations (IREs), under the Pennsylvania Workers’ Compensation Act, have been discussed in this blog before. Basically, the IRE process enables the workers’ comp insurance carrier to switch an injured workers’ disability status to partial if there is a whole body impairment of less than 50% (a ridiculously high standard). [This does not impact the amount of the benefits being received or the access the medical treatment for the work injury].

Recently, the Commonwealth Court of Pennsylvania faced the question of whether an IRE determination is valid if it provides for no degree of impairment for a diagnosis the injured worker still has, but is at that time asymptomatic (and, whether the IRE is then later void, because that very same diagnosis is again causing symptoms).

In this decision, Westmoreland Regional Hospital v. Workers’ Compensation Appeal Board (Pickford), the injured worker was left out in the cold by the Court. The Court concluded that the IRE only has to consider the injured worker’s condition at the moment of the IRE. Since the injured worker had no objective evidence of her brachial plexopathy or Complex Regional Pain Syndrome (CRPS, formerly known as Reflex Sympathetic Dystrophy or RSD) at the time of the IRE, zero impairment for those conditions was correct. The Court found largely irrelevant that within several months of the IRE, the conditions were again revealing objective evidence of impairment.

Instead, the Court noted that the injured worker could simply file a Petition for Reinstatement, as long as there was evidence that the whole body impairment was greater than 50%. Since this standard is so ridiculously high, though, few injured workers are able to meet this standard. Indeed, since a “whole body impairment” has nothing to do with “disability,” it would seem this entire scheme is flawed. This is just further proof of how the injured worker is viewed in the State of Pennsylvania.

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