Impairment Ratings Under The Pennsylvania Workers’ Compensation Act- IRE Doctor Must Have An Active Clinical Practice Of At Least 20 Hours Per Week

In a great Decision by the Commonwealth Court of Pennsylvania in Verizon Pennsylvania, Inc. v. WCAB (Ketterer), No 1188 CD 2013, the notion that an impairment rating physician must have at least 20 hours of clinical practice per week was affirmed. The insurer in this case tried to modify Claimant’s benefits based on an IRE that came back at less than the 50% threshold. However, when cross examining the IRE physician, Claimant’s counsel learned that the physician didn’t have an active clinical practice at the time, but was merely doing Independent Medical Exams, case evaluations, etc.

The Appeal Board ruled in Claimant’s favor and the Commonwealth Court agreed- pointing to the plain language of Section 306 (a2) of the Pennsylvania Workers’ Compensation Act.

This is a favorable case for injured workers. The Court upheld the basic principle that the IRE physician must be actively engaged in preventative care and the management of medical conditions.

If you are not familiar with Impairment Ratings under the PA Work Comp Law, they are normally requested within 60 days of the expiration of the receipt by an injured worker of 104 weeks of total disability benefits (full work comp checks for 2 years). Most IREs come in well under 50% impairment which means the injured worker’s checks get capped at 500 weeks. It’s a mechanism for employers/insurer to put a cap on the benefits and see a “light at the end of the tunnel.”

For more info about PA Work Comp Law, call Certified Work Comp Specialist, Michael W. Cardamone at (215) 206-9068 or email MyPhillyWorkersComp@Gmail.com for a free and prompt consult.

The Cardamone Law Firm is a rare, boutique law firm which dedicates 100% of its practice to the strong representation of injured workers.