Important Changes to Workers’ Compensation Law

As we wrote last summer, the Supreme Court of Pennsylvania issued a significant decision for injured workers.  It ruled that the Impairment Rating Evaluation (“IRE”) section of the Pennsylvania Workers’ Compensation Act was unconstitutional.

500 Weeks or Ten Year Limit on Workers’ Compensation is Unconstitutional

You may have heard of the “500 weeks” or “10 year” limit in workers’ compensation cases. This limited workers’ compensation payments to only 500 weeks if an evaluation deemed the injured worker only “partially” disabled.

Under this provision, insurance companies could send injured workers to an Impairment Rating Evaluation (IRE). If the IRE determined that the impairment was less than 50%, then insurance companies would deem the person to be on “partial” disability instead of total disability and could stop paying benefits after 500 weeks expired.

However, the Pennsylvania Supreme Court said no!  This section of the workers’ compensation law is unconstitutional and they struck it down.

What Does this Mean for Workers Already Affected by the Provision?

While the court’s decision was a victory for injured workers, it did not address some significant issues for Claimants whose benefits insurers had already modified under an IRE:

• Did Claimants waive the right to request a reinstatement to total disability benefits if they did not appeal the IRE determination; and,
• Did the decision apply retroactively?

What is Next for Injured Workers?

Two recent cases have tried to make sense of the Supreme Court’s decision.

In these decisions, lower courts said Claimants who failed to appeal an IRE ruling at the time it was made, can still seek to reinstatement to total disability benefits.  This is good!  It means it is not too late for you to appeal an IRE determined a long time ago.

However, one court did place some limits on its decision.  First, it places the burden on Claimants to prove that they remain disabled because of their work-related injury.  The burden is relatively easy. Claimants only need to testify that they remain in pain and disabled because of the work injury.  No medical testimony is necessary.

Second, but more troubling, is the court’s ruling that the reinstatement only goes back to the date that the Claimant filed the reinstatement petition.  It does not go back to the date of the original IRE.  In some cases, the difference in lost benefits can be significant.

We will continue to fight for our clients and argue that the benefits should go back to the initial IRE decision, especially since the Pennsylvania Supreme Court determined that provision unconstitutional.

What Do These Decisions Mean for You?

These decisions may have a significant effect on your workers’ compensation benefits depending on the status of your case:

• If your benefits were modified to “partial disability” based on an IRE exam that determined you were less than 50% disabled, and you continue to receive partial disability benefits, you must file a reinstatement petition to change your status to “total” disability.

What Should You Do?

If you or someone you know is on “partial” disability because of the IRE or they were on partial disability because of IRE and their payments stopped, they should contact a Workers’ Compensation lawyer in Philadelphia at Galfand Berger to learn more about their rights.  Call us for a free consultation at 800-222-8792 or contact us online.