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  1. #1
    Join Date
    Mar 2009
    Posts
    33

    Default Impairment Rating

    Are impairment ratings most likely used in determining a settlement?
    Can they change the amount of my checks or lessen the 500 week period?
    Thanks
    Laurie

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Impairment Rating

    Are impairment ratings most likely used in determining a settlement?
    Can they change the amount of my checks or lessen the 500 week period?
    Yes, and Yes. You'd have to have a rating to determine the amount of impairment you have suffered due to this injury.
    The rating will determine how many weeks of indemnity is to be paid.
    You can enter into an agreement to settle the claim any time the parties agree, with or without the rating.
    You probably shouldn't count on 500 weeks max unless you are rated 50% or more, and continue to be 'totally disabled' under the rules.

    You can find information on impairment ratings/awards here http://www.dli.state.pa.us/landi/cwp...q=217906#123sb
    Subchapter B. Impairment Ratings

    § 123.101. Purpose.

    This subchapter interprets section 306(a.2) of the act (77 P. S. § 511.2) which provides for a determination of whole body impairment due to the compensable injury after the receipt of 104 weeks of total disability compensation, unless otherwise agreed to by the parties.

    (d) If the evaluation results in an impairment rating of less than 50%, the employe shall receive benefits partial in character. To adjust the status of the employe’s benefits from total to partial, the insurer shall provide notice to the employe, the employe’s counsel, if known, and the Department, on Form LIBC-764, “Notice of Change in Workers’ Compensation Disability Status,’’ of the following:

    (1) The evaluation has resulted in an impairment rating of less than 50%.
    (2) Sixty days from the date of the notice the employe’s benefit status shall be adjusted from total to partial.

    (3) The adjustment of benefit status does not change the amount of the weekly workers’ compensation benefit.

    (4) An employe may only receive partial disability benefits for a maximum of 500 weeks.

    (5) The employe may appeal the adjustment of benefit status to a workers’ compensation judge by filing a Petition for Review with the Department.

    (e) If the evaluation results in an impairment rating that is equal to or greater than 50%, the employe shall be presumed to be totally disabled and shall continue to receive total disability compensation. The presumption of total disability may be rebutted at any time by a demonstration of earning power in accordance with section 306(b)(2) of the act (77 P. S. § 512(b)(2)) or by a subsequent IRE which results in an impairment rating of less than 50%.

    (f) At any time during the receipt of 500 weeks of partial disability compensation, the employe may appeal the adjustment of benefit status to a workers’ compensation judge by filing a Petition for Review.
    If you receive a impairment lesser of 50%, you would be entitled to that % of the 500 weeks. eg. a rating of 25% X 500 = 125wks, X your rate = the amount of your PPD indemnity.

    EE/IW can enter into an agreement with the ER/IC at any time...but the IRE exam can't take place until after the 104 weeks of temp disability has been exhausted...and then there are 60 days for the IRE to be requested.
    123.102. IRE requests.

    (a) During the 60-day period subsequent to the expiration of the employe’s receipt of 104 weeks of total disability benefits, the insurer may request the employe’s attendance at an IRE. If the evaluation is scheduled to occur during this 60-day time period, the adjustment of the benefit status shall relate back to the expiration of the employe’s receipt of 104 weeks of total disability benefits. In all other cases, the adjustment of the disability status shall be effective as of the date of the evaluation or as determined by the evaluating physician.

    (b) Absent agreement between the insurer and the employe, an IRE may not be performed prior to the expiration of the employe’s receipt of 104 weeks of total disability benefits.
    Depending on your injury/body part, you could be entitled to a scheduled loss award.
    And, you could be eligible for VR benefits if the situation warrants.

  3. #3
    Join Date
    Dec 2007
    Location
    Tunkhannock, PA
    Posts
    1,111

    Default Re: Impairment Rating

    If you receive a impairment lesser of 50%, you would be entitled to that % of the 500 weeks. eg. a rating of 25% X 500 = 125wks, X your rate = the amount of your PPD indemnity.

    I can’t agree with this part. Even if the impairment rating is 0% you are still potentially entitled to the full 500 weeks. The way the IRE works is that it converts total disability benefits to partial disability benefits when the impairment rating is below 50%. Partial disability benefits are capped at 500 weeks, but there is not a cap on the receipt of total disability benefits. Therefore, when the conversion occurs, the entitlement to ongoing wage loss benefits in the form of partial disability benefits is capped at the 500 weeks and to receive more you would have to show an entitlement to a reinstatement of total disability benefits.
    Timothy D. Belt, Esquire
    Helping injured workers in Northeast Pennsylvania.
    belt-law@belt-law.com
    www.belt-law.com

    DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The information given is based strictly upon the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.

  4. #4
    Join Date
    Mar 2009
    Posts
    33

    Default Re: Impairment Rating

    okay let me see if i understand.
    if my impairment rating is say 5%, this benefit is paid out in addition to my regular checks i have been recieving?
    If the I/C wants to settle, how does the IR come into play.
    Do they use the 500 weeks x my weekly check amount to get an idea for an offer. I understand they commanly use about 4 years which for me would be 40,000 per year x 4 years = 160,000
    and also add in my impairment rating say 5% x 3weeks = 1500.
    I guess I'm asking if i don't accept a settlement will my capped weeks and my check amounts remain at what they are now evan though i go from total to a
    partial?

    Thanks
    Laurie

  5. #5
    Join Date
    Dec 2007
    Location
    Tunkhannock, PA
    Posts
    1,111

    Default Re: Impairment Rating

    You don’t get both your regular checks and the 500 weeks. Your temporary total disability is converted to partial disability, which is capped at 500 weeks. The only percentage that matters is 50% or greater because if your impairment is at this level the conversion does not occur. The concept of receiving your impairment percentage times the 500 weeks does not exist in PA. The only time the 500 weeks starts to affect settlement value is when you have received a portion of the 500 weeks. In other words, if you have already received 400 of the 500 weeks, your settlement value will be less than 2 years since your remaining entitlement is less than 2 years.
    Timothy D. Belt, Esquire
    Helping injured workers in Northeast Pennsylvania.
    belt-law@belt-law.com
    www.belt-law.com

    DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The information given is based strictly upon the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.

  6. #6
    Join Date
    Mar 2009
    Posts
    33

    Default Re: Impairment Rating

    thank-you so much, i guess i better stick to the pa postings.
    laurie

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