Your IRE Doctor May Not Be Qualified

By: Thomas C. Baumann

Injured workers who have received 104 weeks of total disability benefits can be required to submit to what the Worker’s Compensation act calls an impairment rating evaluation or IRE. The purpose of the examination is to rate the whole body impairment of the injured worker under the American Medical Association Guides to the Evaluation of Permanent Impairment. If the injured worker’s whole body impairment is found to be less than 50%, compensation converts from total disability to partial disability. This puts a limit on benefits to 500 weeks from the date of the exam.

The Bureau of Worker’s Compensation requires physicians who perform IREs to meet certain qualifications:

—Be board certified and licensed in Pennsylvania

—Be active in clinical practice at least 20 hours per week. Section 123.103 of the act 57 regulations defines active in clinical practice as follows:” the act of providing preventive care and the evaluation, treatment and management of medical conditions of patients on an ongoing basis.”

This would seem to rule out a retired doctor who limits his practice to performing independent medical evaluations or serving as a reviewing doctor for purposes of utilization review. It would also appear to rule out a physician who’s only treating practice was as an emergency room physician, as that would not appear to involve managing treatment on an ongoing basis.

If an injured worker is asked to submit to a rating examination, he or she should talk to a lawyer if they have not already done so. There may be ways to challenge the adverse effects of a rating evaluation. Only an experienced workers compensation attorney would be able to recognize the potential challenges. Here at Abes Baumann, we have highly experienced attorneys with many years of practice under their belt. Each of them is able to recognize the issues regarding this matter.



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