This is one of the official workers' compensation forms for the state of Pennsylvania.
Pittsburgh Pennsylvania Request for Physician to Perform Impairment Rating for Workers' Compensation
Category:
State:
Pennsylvania
City:
Pittsburgh
Control #:
PA-LIBC766-WC
Format:
PDF
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How to fill out Pennsylvania Request For Physician To Perform Impairment Rating For Workers' Compensation?
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FAQ
The impairment rating is a percentage that represents the extent of a whole person impairment of the employee, based on the organ or body function affected by a covered illness or illnesses.
Permanent Physical Impairment FAQs (PDF) What is a PPI assessment? A PPI assessment is a medical examination to determine and measure the extent of the permanent impairment. It begins with a complete review of the claim file and is followed by a thorough physical examination of the compensable injury.
A worker with a 0 percent impairment rating is considered to have no impairment at all. Therefore, such a worker is expected to continue with their daily tasks as they would before the injury.
To calculate the impairment award, the CE multiplies the percentage points of the impairment rating of the employee's covered illness or illnesses by $2,500.00. For example, if a physician assigns an impairment rating of 40% or 40 points, the CE multiplies 40 by $2,500.00, to equal a $100,000.00 impairment award.
An impairment rating can also be calculated based on the percentage of the entire body. This usually depends on the personal injury laws of that particular state. For example, a 30 percent bodily impairment rating means the victim has suffered impairment affecting at least 30 percent of their body.
In Pennsylvania, an injured worker is limited by their employer's list of healthcare providers for 90 days after the date of their first visit. After 90 days, you can treat your injury or illness with any doctor of your choice.
A worker who suffers a permanent impairment as a result of a work- related injury may be entitled to a lump sum payment for Permanent Functional Impairment (PFI). The PFI benefit recognizes non-economic loss, as opposed to loss of earning capacity, and is based on measurable loss of bodily function.
An impairment class broadly brackets the percentage impairment that the claimant might be awarded. For most conditions, the classes are as follows: ? Class 0: No objective problem. ? Class 1: Mild problem. ? Class 2: Moderate problem.
In simple terms, an IRE is an examination done by a doctor who must follow the latest edition of the American Medical Association's Guidelines for Permanent Impairment, to determine what percentage of the injured worker's body is impaired.
An Impairment Rating Evaluation (IRE) is a medical examination requested by the insurer and/or their counsel to determine an injured worker's whole-body impairment due to the compensable injury.