As we have addressed in a previous blog post, discussing the case of City of Philadelphia v. Turner (Workers’ Compensation Appeal Board), a Workers’ Compensation Judge (WCJ) cannot allow the conditions considered by an Impairment Rating Evaluation (IRE) to be only those conditions formally accepted by the workers’ compensation insurance company. Instead, the IRE physician must consider all conditions “due to” the work injury (in his or her medical opinion).
Just to refresh your recollection, an IRE is a tool available to PA workers’ compensation insurance carriers, which allows the status of workers’ comp benefits to be switched from “total” (for which there is no specific time limit) to “partial” (for which there is a maximum of 500 weeks available), if the “whole body impairment” (WBI) of the injured worker is found to be less than 35% (an extremely difficult standard to reach). More detail on the IRE process can be found on our website here.
In a recent case, the Commonwealth Court of Pennsylvania faced this issue again, though in a slightly different context. In the Turner case, the only medical evidence was the IRE physician, who was presented by the workers’ comp insurer. Since that physician did not consider all conditions he believed to be “due to” the work injury, the Court was able to simply affirm the decision of the WCJ, and find that the insurer failed to meet its burden under the Pennsylvania Workers’ Compensation Act.