Permanent Restrictions for Workers’ Comp in PA

Permanent restrictions for workers’ comp are a big deal in Pennsylvania. It means you are unlikely to fully recover from your work injury. In addition, it means you will likely continue living with pain and limitations for the rest of your life. Permanent restrictions can also lead to lots of changes in your worker’s comp case, including:

• Light-Duty Job Offer
• Independent Medical Evaluation
• Impairment Rating Evaluation
• Vocational Evaluation

What Are Permanent Restrictions for Workers’ Comp?

Permanent restrictions are your doctor’s orders to never return to regular work. These are usually only issued if your doctor believes you will never fully recover from your injury.

Often times, after you suffer a work injury and start treatment with a doctor, you will be given work restrictions. Sometimes, your doctor will take you completely out of work. Other times, your doctor may allow you to return to work with certain limitations. These are called light-duty restrictions. When you have light duty restrictions, your employer has the option of trying to give you work that complies with your restrictions.

However, as time goes on, most work injuries improve. Permanent restrictions are rare because most injured workers can return to their normal daily life at some point. This is true even if you and your employer disagree about exactly when you recover.

On the other hand, if you are unable to get back to normal, your doctor may give you permanent restrictions. When this happens, it usually means the doctor believes you have reached a point in your recovery called “Maximum Medical Improvement,” or MMI.  According to the Pennsylvania Department of Labor, MMI means that your condition is unlikely to improve substantially going into the future, regardless of whether you get additional medical treatment. In other words, you have likely recovered from your work injury as much as you possibly can. Unfortunately, you will have to learn to live with your pain and limitations.

Will Everybody Agree With My Permanent Restrictions?

Many times, doctors will disagree whether you should have permanent restrictions for your workers’ comp injury. We frequently see these disagreements:

• You have multiple doctors, but not all of them agree that you have permanent restrictions. This could be because doctors with different specialties view your work injury differently.
• Your doctor believes you have permanent restrictions, but your employer’s doctor believes you have recovered from your work injury.
• Your doctor has not said anything about permanency, but you attended an Independent Medical Evaluation where the doctor said you have permanent restrictions.

In addition, you can still look on the bright side if you are given permanent restrictions. Since doctors can disagree whether you need permanent restrictions, you may still be able to fully recover from your work injury.

What Happens Now? Next Steps After Permanent Restrictions.

Once you are given permanent restrictions, lots of things can happen with your workers’ comp case. We have previously written about workers’ compensation benefits that are available in Pennsylvania. If the workers’ comp insurance company does nothing, you could receive wage loss and medical benefits for the rest of your life. However, this almost never happens. Instead, the workers’ comp insurance carrier has many tools they can use to negatively affect your benefits.

As a quick note, if you need to know how to obtain workers’ comp benefits in Pennsylvania, we have an entire article dedicated to that topic for you. Click here.

Light-Duty Job Offer

When you have permanent restrictions, your employer may choose to offer you light-duty work. Here, your employer will review your permanent restrictions and decide if they can give you work. Some employers have sophisticated light-duty programs that make it easy to offer you work. Other employers may have to make modifications to some of their regular jobs to comply with your permanent restrictions. Finally, some employers may not be able to accommodate your permanent restrictions at all.

Most employers will offer you light-duty work if they can. This is because bringing you back to a light-duty job reduces the amount of workers’ comp wage loss benefits they may have to pay you. Unfortunately, bringing you back to a light-duty job will also likely reduce the value of your workers’ comp settlement in the future.

Independent Medical Evaluation

Workers’ comp insurance carriers frequently send injured workers to Independent Medical Evaluations, or IMEs, in response to permanent restrictions for workers’ comp. Here, the insurance carrier likely disagrees with your doctor’s opinion that you require permanent restrictions.  As a result, they will send you to an evaluation with their own doctor that they pay for.

Unfortunately, workers’ compensation insurance carriers are allowed to send you to IMEs during your case.  In general, they can send you for one of these evaluations about once every six months.

Here is what happens at an IME:

• The IME doctor reviews your treatment records.
• You undergo a physical examination.
• The IME doctor writes a report.
• The report is sent to the workers’ compensation insurance carrier.
• The insurance adjuster reviews the report and decides what action to take against your benefits.

Impairment Rating Evaluation

Permanent restrictions for workers’ comp often times lead to an Impairment Rating Evaluation, or IRE. At first glance, this may seem very similar to the IME we mentioned earlier. However, IREs are very different. In effect, an IRE may allow the workers’ comp insurance carrier to place a cap on your wage loss benefits.

IREs also have a complicated history. Not long ago, the Pennsylvania Supreme Court deemed IREs unconstitutional. In 2018, however, Pennsylvania enacted a new law that brought back IREs. Generally, the new law established that IRE doctors must evaluate injured workers according to the 6th edition of the AMA Guides to Evaluation of Permanent Impairment. In theory, the new law also made it more difficult to place a cap on wage loss benefits.

Workers comp must pay you 104 weeks of full wage loss benefits before sending you to an IRE. If you have received wage loss benefits for this long, odds are you have received permanent restrictions from your doctor. The IRE doctor will examine your whole body, not just the area where you have a work injury. The doctor’s job is to determine the percentage of your entire body function that is impaired by your work injury.

The New IRE Law

Under the new law, if the IRE doctor believes that your entire body is 35% or more impaired due to your work injury, your benefits remain intact. On the other hand, if the IRE doctor believes your entire body is less than 35% impaired due to your work injury, you case changes dramatically:

• The status of your case changes from “total disability” to “partial disability”
• The amount of your wage loss checks does not change, but your benefits are capped
• You can receive a maximum of 500 additional weeks of wage loss benefits
• After the 500 weeks passes, your wage loss checks stop

As you can see, the 500-week cap is a very big deal. This is a little more than 9.5 additional years of benefits, which sounds like a long time. However, 9.5 additional years of wage loss benefits does not do you much good if you were not planning on retiring in that period of time prior to your work injury. The result, therefore, is that your wage loss checks may suddenly stop but you still have permanent restrictions and cannot get back to work.

Vocational Evaluation

Permanent restrictions frequently lead to vocational evaluations. This is another method workers’ comp uses to limit or stop your wage loss benefits. Importantly, this comes into play if your employer is unable to offer you a job within your permanent restrictions.

After learning of your permanent restrictions, your employer likely tried to offer you light-duty work. However, they may not have any work that you can do with those restrictions. If this is true, your employer may send you to a vocational evaluation.

Here, workers’ comp hires a vocational expert. The vocational expert will do the following:

• Interview you about your education, work history, medical treatment, and physical limitations.
• Based on information gathered during the interview, the vocational expert conducts a survey of jobs available in your area that may comply with your permanent restrictions.
• Finally, the vocational expert writes a report and sends it to both you and workers’ comp.

Once you receive the report, you have a responsibility to contact each of the jobs to see if they will hire you. Even though you have permanent restrictions, you may be able to work. If you are hired at one of the jobs, workers’ comp will ask a judge to modify your wage loss benefits. Start making the same or more as you did before your injury occurred and your wage loss benefits will stop.  If you are making less, your wage loss benefits will be reduced.

I Just Got Permanent Restrictions for Workers’ Comp, What Should I Do?

If you have not done so already, it is very important to hire an attorney after you receive permanent restrictions. As you can see, getting permanent restrictions can have a huge effect on your case. Workers’ comp is not going to just sit around and pay your benefits without a fight.

Permanent restrictions actually provide workers’ comp with many opportunities to limit or stop your benefits. Therefore, you want to retain an attorney to protect and fight for your rights in this situation.

If you have received permanent restrictions for workers’ comp, call the experienced attorneys at Kitay Law Offices for a free consultation. Contact us at 888-KITAYLAW and we will guide you every step of the way and fight to protect your rights.