By: Sandra Weigel Kokal

As discussed in prior blogs, the Insurance Company may try to limit your benefits with the Impairment Rating Evaluation (IRE). An IRE is a physical examination where the doctor determines your level of disability. After receiving 104 weeks of benefits, the PA Workers’ Compensation Act requires an injured worker to submit to an IRE. If the doctor finds that your impairment is over 50%, you will continue to receive total disability workers’ compensation benefits. However, if the doctor finds your impairment is less than 50%, your status will change from total to partial disability.

A recent Supreme Court case, Duffey v. WCAB (Trola-Dyne, Inc.) has given doctors more direction on what is required in their IRE examinations. According to the Supreme Court decision, a doctor performing an IRE must consider ALL of the conditions that the doctor believes are related to the work injury, including any psychological injuries (such as depression or post traumatic stress disorder) that might occur as a result of the work injury. Therefore, even though the description of your injury on the Notice of Compensation Payable (NCP) might not include all injuries, the doctor must address all possible work related injuries. The Supreme Court stated that the doctor is required to render a detailed whole person evaluation in order to support any change in workers’ compensation benefits. This means the whole body evaluation cannot be withheld based on the employer’s description of your injury on the NCP. Your IRE could be found invalid if the doctor fails to perform a whole body impairment evaluation.

Since an IRE can limit your workers’ compensation benefits, the best way to protect yourself is to contact one of the attorneys at Abes Baumann to review the IRE and determine its accuracy.

By: James R. Burn, Jr.

Many of us are familiar with the tale of the Trojan Horse. Achilles and his soldiers, in order to defeat Troy and obtain access to their kingdom, created a Trojan Horse and wheeled it up to the gates of Troy. Inside of the horse, Achilles and his soldiers waited for the Trojans to wheel the Trojan Horse through their impenetrable walls. Once inside the walls, they slipped out and defeated their enemy.

We often advise our clients to beware of insurance companies bearing gifts. Insurance carriers and their adjusters will often display what would appear to be wonderful acts of kindness to injured workers. They may offer to have a nurse come with you to your examinations. They may tell you that they are looking out for your best interests and offer you what they say is a very fair settlement.

These “gifts” from insurance carriers are most times nothing more than a Trojan Horse. They try to earn your trust and allow you to lower your guard at which time you find yourself out of benefits or back to work before you are physically ready.

We caution injured workers from being fooled by insurance carriers and their Trojan Horse tactics. Please feel free to contact our firm and talk to an attorney for free about your workers’ compensation case and “friendly” insurance adjusters.