IRE finding no objective evidence of accepted work injury on date of examination may validly assign a zero impairment rating for that condition.
The claimant sustained a work injury which included judicially determined conditions of reflex sympathetic dystrophy (RSD) and brachial plexus stretch. The employer obtained an IRE to determine the degree of whole body impairment under Section 306(a.2) of the Act. The IRE physician found no objective evidence of either the RSD or the brachial plexus injury, even though he acknowledged these to be work-related conditions. The AMA Guides to the Evaluation of Permanent Impairment require objective evidence of a condition and that the condition exhibit a sensory or motor impairment. The employer petitioned to modify benefits based upon the 22% IRE evaluation, which included 0% for the RSD and brachial plexus stretch. The workers' compensation judge denied the petition because it did not include a rating for the two acknowledged injuries and also because the treating physician found the claimant to exhibit objective evidence of RSD five months after the IRE.
After the Appeal Board affirmed, the Commonwealth Court reversed. The court first found that an IRE physician does not have to assign an impairment rating greater than 0% in the absence of objective evidence of the condition on the date of the IRE evaluation. In so holding, the court noted that both the Act and the AMA Guides require that the impairment must be based on the claimant's condition on the date of the IRE and that it is not a survey of the claimant's injuries over a period of time. Unlike a finding of full recovery, which may be challenged on the basis of medical evidence showing the claimant's disability from work over time, an IRE is limited to impairment on the date of the exam. In this case, the claimant's physician had examined the claimant the day before the IRE and confirmed there was no objective evidence of RSD, but stated that the condition waxes and wanes, and found such evidence months later.
Case Law Alert - 1st Qtr 2012