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How can workers’ compensation benefits be reduced or stopped?

On Behalf of | Mar 25, 2024 | Workers' Compensation

Being injured at work can disrupt your life in unexpected ways. You can suddenly be cut off from the wages that you’ve come to depend on, which can be especially hurtful when you need expensive medical care to try to recover from your injuries.

Fortunately, you can avail yourself of the workers’ compensation system, which can provide you with consistent payments to help offset the losses you’ve faced because of your workplace accident. The process can be challenging depending on the facts of your case, but if you’re successful on your claim, then you might breathe a sigh of relief knowing that you have the support you need to get by while you focus on your recovery.

However, even if you succeed on a workers’ compensation claim, you could still be at risk of having your benefits reduced or stopped at some point. That can be nerve-wracking to think about, but it’s a reality that you might have to confront. That’s why in this post we want to look at some of the top reasons why workers’ compensation benefits are reduced or stopped so that you know what you need to be watching for as you proceed with your recovery.

Top reasons why your workers’ compensation benefits can be reduced or stopped?

If you’re not careful, then you could suddenly be hit with benefit reduction or elimination. Here are some of the top reasons why an insurance company may take that action against you:

  • Surveillance video evidence: Some insurance companies go so far as to hire private investigators to follow injured workers around. The hope is that they’ll be able to catch you engaging in activities that don’t align with your claimed injuries. If they’re able to catch you on video doing something that you probably shouldn’t be doing, then they’ll use that evidence to try to block you from recovering additional benefits.
  • Independent medical examination results: The insurance company is probably going to require you to submit to a medical examination by what they claim to be an independent third-party medical professional. If this doctor finds that your injuries aren’t severe enough to prevent you from working, then your benefits will likely cease.
  • Lapse in medical care: When you receive workers’ compensation benefits, the expectation is that you’ll seek out needed medical care so that you can hopefully improve your condition and eventually return to work. However, if you forego needed medical care, then the insurance company will probably argue that your actions demonstrate that you don’t need the treatment you claim, thus justifying a denial of ongoing workers’ compensation benefits.
  • Refusal of light duty work requirement: The insurance company handling your workers’ compensation case may require you to return to light duty work. If you feel that you’re unable to work at all and refuse to comply with this obligation, then the insurance company will use that as justification to halt your benefits.

What to do if you’re facing modification of your workers’ compensation benefits

You have to carefully jump through all the hoops if you want to obtain and maintain workers’ compensation benefits. Don’t just take the insurance company at their word, though. Make sure you have evidence to back up your claim, seek second and third medical opinions if you need to counter an independent medical examiner, and be sure to act in accordance with your injuries. And if you’re worried about how to navigate the workers’ compensation process at any point, then be sure to turn for the help you need to aggressively advocate in a way that protects your interests.