Can Workers' Comp Stop Payments Without Notice?

Workers compensation benefits stopped without notice

After receiving an award for workers' compensation, a person may be out of work recovering from an injury or illness. Workers' compensation payments are critical to sustaining a person's quality of life while not working. It can be worrisome to think that payments may stop suddenly. Can workers' compensation discontinue payments without notice?

Most often, injured workers do not need to worry about this unless (and until) they learn about termination of benefits from a notice sent from the employer or the employer's workers' comp insurer. 

In this guide, we'll discuss when you may be at risk of losing workers compensation benefits. Our workers' compensation attorneys can help answer specific questions you have about your case.

To learn more about workers’ comp payments or filing a claim, call (516) 997-0997 or contact us online to speak with an attorney today.

What Is Workers' Compensation?

Workers' compensation is a type of financial compensation provided to people hurt on the job. Specifically, workers' compensation insurance provides medical and wage benefits to people who become ill or are injured while engaging in activities for their employer. 

Each state mandates that some employers offer this type of insurance to help provide financial support to workers. The amount of medical and wage benefits differ from one state to the next.

In New York State, nearly all employers must provide workers' compensation coverage for their employees under the state's laws, according to New York State.

Workers' compensation is a type of social insurance. That's because it relies on a kind of social contract between a company/management and employees/labor. When employers purchase and maintain workers' comp insurance, they have protection from civil suits brought against them by workers who suffer injuries or illness as a result of their job. There are numerous limitations on this, though.

Workers' compensation may provide financial support for various financial losses a person experiences after being hurt at work. This may include medical expenses, lost wages, and rehabilitation costs as needed. 

It may also pay benefits to an employee's family that dies on the job. Insurance companies pay out these benefits based on the length of the recovery period.

Can Workers' Comp Stop Your Payments Without Notice?

Workers' comp benefits can terminate even if you have not improved and continue to be out of work. It is not likely this would happen suddenly. Instead, you should receive some warning about what's occurring.

Most often, an employer sends a Notice of Suspension to you after you return to work at full age or if they file a petition to modify your existing benefits. They may aim to change the benefits, reduce them, or completely stop them from occurring. If the employer files this notification, you will receive a letter that explains what is happening and, in most cases, why.

It may be possible for you to file a Notice of Petition to help stop this from occurring. It's a bit of a complex process and one you need to take action on swiftly to prevent losing your benefits. That's why it's best to work with a workers' comp attorney to help you with this petition.

An employer cannot simply stop paying you these benefits. There is a process they must take to notify you of the change. You have the right to petition against that change as well. That provides you with some protection against losing your benefits for no reason.

Often, employees worry about their benefits being modified or terminated for various reasons. Some warning signs that an employer may be taking this step include:

  • You receive an Impairment Rating Evaluation. This is a type of medical examination of your work-related injury. It provides the workers' compensation insurance company with insight into your workers' compensation claims, including the level of disability you have from the injury.
  • You receive a notice that the insurance company wants an Independent Medical Exam, IME.

Though it sounds like it is set up to be fair, that's not the case as you cannot choose your doctor for this medical exam. This may be a request when the insurance company disagrees with your medical diagnosis or medical treatment. It also is a requirement if a judge is trying to settle a dispute between an employee and an employer or insurance carrier over disability benefits.

Work with your law firm to determine where you stand in either of these situations. Find out your requirements and what steps you need to take to continue getting compensation for the medical care you need.

The question is, why would they want to stop payments? There could be a number of reasons they take this step.

Reasons Workers Compensation Would Stop or Change

The employer's insurance company or your employer may wish to change your medical benefits for various reasons based on the evidence or information they have about your comp case. Sometimes a judge may tell the employer they can make a change based on the evidence or information related to your case. An employer may have approached a workers' compensation judge for various reasons because you are not following the rules of the claim.

Here are some examples of reasons, but be sure to seek legal advice based on your case from your workers' compensation attorney.

You refuse to undergo a medical examination

Often, individuals need to complete a medical evaluation as a way to show their injuries or the extensiveness of their illness. A medical exam provides information at the start of the claim. In some cases, the workers' comp attorneys working for the employer may also request them over time to determine if you are still eligible to receive your weekly benefits.

You are declining reasonable medical treatment

Information from a treating physician about your lack of pursuing medical treatment or following the recommendations of a doctor may be a factor in why the insurer hopes to reduce or terminate your benefits. Providing this type of care aims to help you achieve maximum medical improvement. That requires care.

You have been sentenced to jail or prison.

In some cases, your benefits may no longer be available to you if you are sentenced to jail or prison time. That is a requirement under the workers' compensation law.

You do not return the employee verification form as required

An employee verification form is a critical document to complete. It is necessary to provide this if you are receiving wage loss benefits. You will need to report any earned wages to the insurance carrier as a result. If you fail to fill them out and return them on time, the insurer may stop your payments. These verification forms are a type of fraud provision and a part of the Workers' Compensation Act. It is a way to ensure you are not receiving any other income. If you are receiving other income, you may not qualify for full disability benefits.

What should you do if your workers' compensation benefits are threatened?

Knowing what to do when workers comp stops paying is essential, but don't wait that long. Instead, if you receive any notification from any related attorney or insurer about your benefits, act immediately to get legal support. Do this before, or as soon as possible, if workers'' comp is not sending checks.

Consult with a New York workers’ compensation lawyer

If you feel your workers' compensation benefits are threatened in any way, set up a time to speak to our attorney in a free consultation. Try to avoid talking to the insurance adjuster without having legal advice available to you. 

Ask all of the questions you need, such as, "When does workers comp stop paying?" and "Can workers company be taken away?" Your attorney will walk you through what to expect in your case.

Your attorney may provide you with insight into your rights and obligations to continue to receive benefits. This may include providing you with a good understanding of what's allowed in terms of full or partial disability. You may also need to go back to work with light-duty if your condition improves enough to do so.

We are happy to provide you with a full case evaluation to discuss what's happening in your situation. Even the most experienced workers may find themselves in this situation. Don't wait to reach out for help if you are.

Plan a visit with your doctor

It may be necessary to show to the insurance adjuster or employer that you are doing the best you can. A medical exam may answer some or all of the questions about your condition to those who need to know. 

Work closely with your treating physician to better outline your current condition. This may include providing insight into whether you can work at all or some, as well as if you are likely to require permanent partial disability (or full disability).

Attend mediation

If you've received a notice of termination, you may want to pursue mediation with the employer to find some level of common ground and compromise. A judge meets with both parties in the case to determine what can be done in the situation. 

You may not need to settle your claim. With the help of a workers' compensation lawyer, you may be able to retain your benefits for your weekly wage, medical bills or reach an agreement for a lump sum payment.

Don't Put Your Claim on the Line – Let Us Help You

Our Long Island Workers’ Comp lawyers are dedicated and available to advise you of your legal rights and help you build a strong claim. Get in contact today!

If you are worried about receiving notice that your benefits are getting suspended or terminated, contact Terry Katz & Associates online or call (516) 997-0997 for a free initial consultation. 

Justin Lieberman, Esq.
Just Lieberman is a Long Island workers' compensation attorney at Terry Katz & Associates, recognized as a "Super Lawyers, Rising Star" for the past four consecutive years.
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