The Pennsylvania Department of Labor and Industry, Bureau of Workers' Compensation, has amended its rules related to Impairment Rating Evaluations (IREs). These changes aim to align the regulations with Act 111 of 2018 and recent case law, ensuring consistency and reducing confusion between the regulations, statutes, and case law.
Below is a summary of the key amendments to the IRE regulations:
Automatic Adjustment of Benefit Status
An employee's benefit status will automatically adjust and relate back to the expiration of the 104 weeks of total disability benefits if the IRE is scheduled during the 60-day period following the expiration of the 104 weeks.
Adjudication for Late IREs
If an IRE is performed outside the 60-day window following the 104 weeks of total disability benefits due to the insurer’s failure to make a timely request, the adjustment of disability status must be subject to adjudication or agreement between the parties.
Use of AMA Guides (6th Edition)
IREs must be performed using the 6th edition of the AMA Guides to the Evaluation of Permanent Impairment.
Lower Impairment Threshold
The impairment rating required to adjust an employee's benefit status from total to partial disability has been changed from less than 50% to less than 35%.
Mandatory Use of Form LIBC-764
Form LIBC-764 must be used when the IRE is requested and performed within the 60-day period following the expiration of 104 weeks of total disability benefits and results in an impairment rating of less than 35%.
Right to Appeal:
Employees retain the right to appeal the adjustment of their benefit status to a workers' compensation judge.
These amendments take effect on January 25, 2025.
For more information or guidance on how these changes may affect your claims, please contact Lee Fiederer.
.png)
.jpeg)
