IREs – Commonwealth Court Clarifies the Issues

In two important decisions, the Commonwealth Court has clarified some disputed issues involving impairment rating evaluations (IREs). In the long-awaited decision in Diehl v. Workers’ Compensation Review Board (IA Construction and Liberty Mutual Insurance), the Court held that an employer seeking to modify a claimant’s disability status based upon an Impairment Rating Evaluation (IRE) requested more than 60 days after a claimant has collected 104 weeks of total disability benefits, must obtain an agreement from the claimant or adjudication that the employee’s condition improved to an impairment rating of less than fifty percent. The employer does not have to prove both earning power and the level of impairment to effect a change in the claimant’s disability status.

Also, in Ford Motor/Visteon Systems v. Workers’ Compensation Appeal Board (Gerlach), the Court ruled that when an employer files a petition seeking to modify a claimant’s benefits based upon an IRE, rather than using the administrative process under the Act, the effective date of the modification is date on which the IRE examination occurred.

Suspension of Benefits Can Occur Only After Conviction and Incarceration

That is the holding in Rogele, Inc. v. Workers’ Compensation Review Board (Mattson), in which the Commonwealth Court affirmed that an employer may suspend a claimant’s benefits only during periods of incarceration following conviction.

Supersedeas Fund Reimbursement – Follow the Rules

An insurer/employer is not entitled to reimbursement from the Supersedeas Fund if the employer violated the Act by unilaterally withholding benefits without filing an appropriate petition, according to the Commonwealth Court in Henkels & McCoy, Inc. v. Workers’ Compensation Review Board (Barner).

Demonstrating Earnings – A Tricky Situation

The Commonwealth Court’s ruling in Alessandro v. Workers’ Compensation Appeal Board (Precision Metal Crafters, LLC) highlights how fact specific many cases become. In Alessandro, the Court was confronted with a situation in which an employer asserted that a claimant was working and the claimant insisted that he was not. The Court affirmed the WCJ’s decision suspending the claimant’s benefits, however, based upon the WCJ’s conclusion that claimant was working, despite claimant’s testimony to the contrary. The Court further affirmed the WCJ’s Order suspending benefits until claimant presented evidence of his earnings at the other alleged job. Thus, the claimant could only seek reinstatement by presenting evidence of his earnings or evidence that his medical condition had changed to the point where a reinstatement of benefits was warranted.