The Bulldog Lawyers at Shor & Levin explain what the “Termination of Benefits” notice means and what you should do to protect your income and your health.
If your employer or its workers compensation insurance carrier sent you a notice of modification or termination of workers compensation benefits, you may be concerned that you will be forced back to work before you have fully recovered. Or, you might be worried about supporting your family until you can work again.
Warning Signs That Your PA Workers’ Compensation Benefits May Change
Has your employer requested an impairment rating evaluation (IRE), an independent medical exam (IME), or an evaluation by a vocational counselor? These tests are often a sign that you employer is seeking to modify your workers’ compensation benefits.
- Impairment Rating Evaluation (IRE): If you have been receiving total disability, your employer may request an impairment rating evaluation. This medical examination must be performed within 60 days of the 104-week anniversary of the start of your benefits. The doctor is chosen by the Pennsylvania Bureau of Workers’ Compensation. If the doctor’s evaluation shows that you have an impairment rating of less than 50 percent, you will be limited to no more than 500 weeks of benefits.
- Independent Medical Exam (IME): Your employer’s insurance company may also require you to undergo an independent medical exam. An IME is very different from an IRE because the physician you see is chosen by your employer or your employer’s insurer. The doctor is paid to search for evidence that you have recovered from your injuries, or have recovered enough to return to work. Your employer can use the doctor’s report as evidence to terminate or modify your benefits.
- Evaluation by a Vocational Counselor: The purpose of a vocational evaluation is to determine if you are capable of working for pay. The vocational expert will determine how your disability affects your earning potential. You may be required to return to work if the counselor determines that there is a lighter duty job available that you are capable of performing, even if you have not fully recovered from your injury or illness.
Modification of Workers Compensation Benefits
If your disability status changes, your employer or its insurance company may seek to modify your benefits. Here are some valid reasons for a modification of benefits.
- You have reached a point in your recovery where you can do some form of work. If you still can’t go back to your old job, your employer has the option of offering you another job that is physically and vocationally appropriate.
- Your IRE shows that you have less than a 50 percent impairment rating.
- The results of your IME, IRE, or vocational assessment show that you are able to perform work.
Termination of Workers Compensation Benefits
Losing your workers’ compensation benefits can be devastating. Your family counts on these payments to make ends meet. What can you do?
Your rights depend on the reason for the termination of benefits. A workers compensation insurance company can legally terminate your benefits for any of the following reasons:
- Your employer or its insurance company has denied your workers’ compensation claim and has sent you notice that they are terminating any temporary compensation.
- The insurance company contested your right to receive workers’ compensation and filed a Termination Petition. A workers’ compensation judge ordered your benefits to be terminated.
- You settled for a lump sum settlement and allowed the insurance company to terminate your benefits in exchange.
- Your 500-week period of partial disability benefits has ended.
- You retired.
- You agreed that you have received full payment (filled out Supplemental Agreement, Agreement to Stop Workers’ Compensation, or Final Receipt) and allowed the insurance company to terminate your benefits.
- Your injury has healed and you have returned to work.
- Your injury has healed and you are able to return to work.
However, your benefits cannot be stopped without good reason. If you are still injured and unable to work, you may still be eligible for benefits. Contact the Bulldog Lawyers. Your employer may have broken the laws that protect injured Pennsylvania workers.
Worried About Your Benefits? Our Bulldog Lawyers Can Help.
If you have received a notice that your workers’ compensation benefits will be modified or terminated, you need to act fast. You have legal options. But, if you wait, you could lose your benefits. Call Shor & Levin at 855-631-2013 to schedule a free, no obligation, case evaluation. Our attorneys will work with you to make sure you receive your benefits until you are ready to go back to work.