The nature of a work-related injury “accepted” as compensable under Pennsylvania workers’ compensation with appropriate formwork has been sacrosanct for decades. It’s not that the injury description cannot be changed, but as written, the description drives employer and insurer obligations concerning not only benefit payments but also evidentiary obligations. Of equal importance, issues previously addressed through litigation through a final decision have been also, for decades, set in stone establishing the judiciary’s primacy over such topics. But now, there is an opening in this process for interpretation and court-imposed change.

An impairment rating evaluation (IRE) is one of the statutory mechanisms utilized by employers and Pennsylvania workers’ compensation insurers to cap injured workers’ disability benefit entitlements to a set 500-week period. An IRE does not address the actual weekly wage loss rate nor does it address medical benefits. The Pennsylvania Commonwealth Court has recently held that an IRE based only upon all “accepted” work-related diagnoses is nonetheless subject to being found invalid. In this case, the IRE physician relied upon the bureau controlling document and a Judge-approved stipulation. But the Commonwealth Court ruled that where the evidence as a whole shows the degree of impairment “due to the compensable injury” reaches or exceeds 35%, nonrecognized, additional injuries must be considered. See Sicilia v. API Roofers Advantage Program (WCAB), No. 747 C.D. 2021, filed June 7, 2022 (Pa. Commw. 2022).