IMPORTANT IRE NOTICE
Impairment Rating Evaluation - Use the Required LIBC-765 to Notice an IRE appointment.
In October 2018, Act 111 restored the Impairment Rating Evaluation (IRE) process. Unfortunately, more than one out of every three IREs are not recorded correctly in WCAIS. As a result, insurers are not complying with § 123.102(e) which requires the insurer to request the employee's attendance at the IRE appointment on the LIBC-765 "Impairment Rating Evaluation Appointment" form.
Did you know that the only valid version of LIBC-765 is only available through WCAIS?
To obtain a valid LIBC-765, insurers must enter the appointment details for the IRE appointment in WCAIS. This will generate a printable version of the LIBC-765 for insurers to mail to the appropriate parties and provide information to the bureau necessary for oversight and reporting efforts.
Why can't we just use the old paper LIBC-765 forms?
When the insurer fails to create the electronic LIBC-765 form, WCAIS does not create a place for the IRE doctor to upload his report and document the percent of impairment. This information is critical for mandated data collection requirements used by the Pennsylvania Compensation Rating Bureau and other agencies to assess the impact that the return of IREs has had on the Workers' Compensation program.
What can we do to be compliant with § 123.102(e) and improve the data?
- Always create an electronic LIBC-765 in WCAIS as soon as an appointment has been made.
- Respond thoroughly and in a timely manner to bureau email inquiries regarding IREs.
- Notify the bureau immediately at email@example.com if
- You decide you want to withdraw or cancel the IRE.
- The appointment is on hold because of litigation.
- You need help performing a WCAIS task related to IRE.
IRE Post Act 111
On Oct. 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