Impairment Rating Evaluation

An Impairment Rating Evaluation (IRE) is a medical examination requested by the insurer to determine a worker’s whole body impairment due to the compensable injury after the worker has received 104 weeks of total disability compensation.

On October 24, 2018, Governor Wolf signed into law Act 111 of 2018, which reestablished the Impairment Rating Evaluation (IRE) process in Pennsylvania. In pertinent part, the new IRE provisions, which will be found in Section 306(a.3) of the Workers' Compensation Act, require IREs to be performed under the 6th edition (second printing April 2009) of the AMA Guides to Evaluation of Permanent Impairment, and set the threshold for the presumption of total disability at thirty-five percent (35%).

In order to make the IRE process available to the workers' compensation community as soon as possible, since Act 111 is effective immediately, the Department of Labor and Industry, Bureau of Workers' Compensation (Bureau) has reactivated the IRE functionality in WCAIS and has resumed the authorization and designation of IRE physicians, to allow for the performance of IREs pursuant to the requirements set forth in Act 111. To maintain consistency, it is anticipated that the process will track the preexisting procedural and regulatory framework, to the extent and in a manner consistent with the provisions of Act 111.

However, please note that despite making this functionality immediately available, the Bureau is still in the process of reviewing and updating its WCAIS screens and forms, and will ultimately seek to amend its regulations, to accurately reflect the new IRE provisions and requirements in Act 111. Until these changes have been completed, some screens and forms generated regarding the IRE process still may contain erroneous language referencing the repealed language and requirements of prior Section 306(a.2), such as "the most recent edition" of the AMA Guides or a fifty-percent (50%) threshold.

Notwithstanding any language to the contrary temporarily found on WCAIS screens or Bureau forms and regulations during this transition, it is expected that all IREs will be conducted and determined consistent with and pursuant to the new statutory requirements set forth in Act 111.