Features
What to Expect During an Impairment Rating Evaluation (IRE)
If you’ve been hurt and are unable to work, you’ll likely be asked to perform an Impairment Rating Evaluation (IRE) at some point. This is an important factor in the process of determining the extent of an injury and its impact on your capacity to work, which will likely influence the benefits you receive from workers’ compensation.
The Purpose of an IRE
An IRE is typically requested by the insurance company handling your workers’ compensation. Its purpose is to assess the extent of your injury and determine if you’re partially or fully impaired. This evaluation quantifies the degree of your impairment, giving a percentage that often dictates the continuation, reduction, or termination of your benefits.
As Calhoon and Kaminsky P.C. explains, “The insurance company doesn’t request an IRE out of mere curiosity. They want to save money on disability payments, and they request an IRE to get information that may allow them to reduce your payments.”
Once you cross a certain threshold of benefits – often around 104 weeks of total disability payments – the insurance company may request an IRE to establish whether you’re considered partially or totally disabled. This classification can significantly impact the duration and amount of your benefits, so it’s important to approach the IRE with a clear understanding of what’s at stake.
4 Steps to Navigating Your IRE
Knowing the process in advance can give you a sense of control during your IRE. Here’s a step-by-step guide to help you prepare and stay informed.
- Selecting the Evaluator
Your IRE will be conducted by a doctor certified to perform impairment evaluations, typically chosen by the insurance company. This physician will use standards established by the American Medical Association (AMA) to determine your impairment rating. Because this doctor is not your personal physician, approach the evaluation objectively and remember that they are there to assess your injury as it aligns with the workers’ compensation system.
It’s crucial to understand that while the physician is responsible for evaluating your injury, they are bound to the guidelines provided, so they may not address the emotional or personal aspects of your situation. If you have any concerns about your assigned evaluator, speak with your workers’ compensation attorney to discuss any red flags or biases.
- Gathering Medical Documentation
Preparation is important for a fair evaluation. Bring any recent medical records related to your injury, including X-rays, MRI results, physical therapy notes, and reports from specialists. Having comprehensive documentation on hand not only supports your case but also provides the evaluator with the full picture of your condition.
Make a list of your symptoms, how they affect your daily life, and any limitations you face. Be honest and detailed – describe your pain, range of motion difficulties, and any challenges performing everyday tasks. This clarity allows the doctor to get a thorough understanding of your impairment, which can result in a more accurate rating.
- Undergoing Physical Examination and Tests
During the evaluation, you’ll undergo a physical examination. The doctor may conduct a series of tests to assess your strength, flexibility, and endurance. These tests could involve walking, lifting, bending, or other physical tasks. The purpose is to measure how well you can function with your injury and to identify any restrictions or limitations.
The evaluation may also involve neurological tests if your injury affects your nerves or cognitive functions. Take these tests seriously and put forth an honest effort, as the results will play a large role in determining your impairment rating. Remember, it’s okay if some tasks are challenging or painful – this only highlights the extent of your injury.
- Awaiting Your Impairment Rating Results
Once the evaluation is complete, the physician will calculate your impairment rating, expressed as a percentage. This rating reflects the severity of your injury and the impact it has on your ability to work. Generally, a rating below a certain threshold, like 50 percent, may result in a classification of partial disability, which could reduce or limit the duration of your benefits. A higher rating may qualify you as totally disabled, allowing you to receive long-term or even lifetime benefits in some cases.
It’s important to review the results with your attorney. They can explain the potential implications of the rating and whether you have grounds to challenge it if you feel it’s not an accurate representation of your impairment.
How an IRE Affects Your Workers’ Compensation Claim
The results of your IRE can have a lasting impact on your workers’ compensation claim. If your rating is low, the insurance company might push to reduce or even stop your benefits altogether, arguing that your injury is less severe than previously determined. However, if your impairment rating is high, you may be eligible for ongoing benefits that provide greater financial stability as you recover.
Keep in mind that your rating isn’t always set in stone. If your condition worsens, you may be able to request a re-evaluation to update your impairment rating. Your attorney can guide you on this process, ensuring your rights are fully protected as your situation evolves.
