Workers’ compensation benefits provide crucial financial support for employees who are injured on the job. However, there are instances when these benefits may be reduced or stopped altogether.
If you find yourself in this situation, understanding your legal options is essential to protect your rights and continue receiving the support you need. Below are the key steps you should take if your workers’ compensation benefits are reduced or stopped. Contact PLBH at (800) 435-7542 to request a free legal consultation.
Why Are Workers’ Compensation Benefits Reduced or Stopped?
Before diving into the legal steps, it’s important to understand the common reasons why workers’ compensation benefits may be reduced or terminated. These include:
- Medical improvement: If your doctor determines that you’ve reached maximum medical improvement (MMI), your benefits may be reduced or stopped. This means your condition has stabilized and is not expected to improve further.
- Return to work: If you are cleared to return to work, either at full capacity or with modified duties, your benefits may be reduced or stopped depending on your new earning capacity.
- Dispute from your employer or insurance: Sometimes, employers or their insurance providers may dispute the severity of your injury or your need for continued benefits, which could result in a reduction or termination.
- Missed deadlines or incomplete paperwork: Failing to submit required medical reports or missing deadlines can also lead to a reduction or termination of benefits.
Step 1: Review the Reason for Benefit Reduction or Termination
The first thing you should do is determine why your benefits were reduced or stopped. Typically, the workers’ compensation insurance company will send you a written notice outlining the reason for the change. This notice will include details about whether the benefits are being reduced or stopped permanently, and it may offer a brief explanation.
Check the following:
- Dates and deadlines: Make sure there are no issues with missed deadlines or incomplete documentation.
- Medical evaluations: Review the most recent medical evaluations and reports to ensure they reflect the current state of your injury.
Step 2: Request a Review or Reconsideration
If your benefits were reduced or stopped due to a medical evaluation or disagreement about your ability to work, you have the right to request a review or reconsideration of the decision.
- Obtain additional medical opinions: You can seek a second opinion from another doctor to support your claim that your injury still requires benefits.
- Submit new evidence: If you have additional medical records or documents that demonstrate the need for continued benefits, make sure to submit them to the insurance company or workers’ compensation board.
Step 3: File an Appeal with the Workers’ Compensation Board
If your initial review request does not result in the reinstatement of your benefits, the next step is to file an official appeal with your state’s workers’ compensation board.
Steps involved in the appeals process:
- Filing the appeal: Make sure to submit your appeal within the deadline specified in the notice. Missing the deadline can limit your legal options.
- Prepare your case: Gather all relevant documentation, including medical records, witness statements, and any other evidence that supports your claim for continued benefits.
- Attend a hearing: You may be required to attend a hearing before a workers’ compensation judge. At this hearing, you can present your case and provide evidence of why your benefits should be reinstated.
Step 4: Consider Filing a Lawsuit
If your benefits are still denied after the appeals process, you may have the option to file a lawsuit against the insurance company or employer. This is typically a last resort, as it involves going through the court system and may take longer to resolve.
- Legal representation: At this stage, having an experienced workers’ compensation attorney is crucial. Your attorney can help gather evidence, build a strong case, and represent you in court.
How PLBH Can Help
If your workers’ compensation benefits have been reduced or stopped, you don’t have to navigate the legal process alone. At PLBH, we are experienced in helping employees fight for their rights and secure the benefits they deserve. We can help you challenge the reduction or termination of your benefits by guiding you through the appeals process and representing your interests.
Contact PLBH Today
If your workers’ compensation benefits have been unfairly reduced or stopped, it’s essential to take action as soon as possible. Contact PLBH at (800) 435-7542 for a consultation and to discuss the legal options available to you. Let us help you protect your rights and ensure that you receive the benefits you are entitled to.