If you’ve been out of work for a long time and just got a letter about an “Impairment Rating Evaluation,” it can feel like the insurance company is trying to put a clock on your recovery. In many cases, that’s exactly what it is. Philly Injury Lawyer helps long-term injured workers understand what an IRE can and can’t do, and protects their benefits through the process.
What an IRE Is
An IRE is a medical exam that gives your work injury a percentage of whole-body impairment, using a medical guide doctors use for rating permanent impairment. It’s different from an IME. It doesn’t ask whether you can work. It measures how permanently impaired you are.
When It Can Happen
The insurer can ask for an IRE after you’ve received 104 weeks (about two years) of total disability benefits. The exam is done by a doctor assigned through the state’s process, not one picked directly by the insurer.
Why the 35% Number Matters
- 35% or higher: you stay on total disability benefits, with no set end date.
- Below 35%: your status can change from total to partial disability. Your weekly check usually stays the same amount, but partial benefits are limited to 500 weeks, which is a little under 10 years.
The change doesn’t end your medical benefits. Your injury-related treatment continues to be paid.
Can a Low Rating Be Challenged?
Yes. You can challenge the rating, and you can also show that you’ve actually lost earning power. Later, if your condition gets worse, you may be able to get another evaluation and return to total disability status if your rating reaches 35% or more within the 500-week period.
What You Should Do
- Don’t skip the IRE. Missing it can hurt you.
- Make sure the doctor has your complete medical records.
- Keep treating and keep good records of your symptoms and limits.
- Talk to a lawyer before agreeing to anything about your status or a settlement.
Facing an IRE? Let’s Talk
Call (215) 735-4800 for a free review. We only get paid if we win. We Win or It’s Free®.
Frequently Asked Questions
Will an IRE lower my weekly check?
Usually not right away. A rating under 35% changes your benefits from total to partial disability, which keeps the same weekly amount but puts a 500-week limit on wage benefits.
Do weeks I’ve already been paid count toward the 500 weeks?
Generally, yes. Weeks of total disability already paid can be credited toward the 500-week limit, which is why it’s important to understand the math in your specific case.
Does an IRE affect a settlement?
It can. Your disability status and how many weeks of benefits may remain both affect what a fair settlement looks like.
Pennsylvania Law in Plain English
Pennsylvania’s IRE rules come from a 2018 change to the Workers’ Compensation Act. After 104 weeks of total disability, an impairment rating under 35% can change you to partial disability, which is capped at 500 weeks. Your medical benefits for the injury continue.
