What Happens When An Employer Modifies, Suspends, or Terminates Your Workers’ Compensation Benefits
Having your workers’ compensation benefits suspended can be incredibly frustrating. An employer may not need to file a petition for a worker’s benefits to become suspended. For instance, if an injured worker returns to work at no decrease in earnings, then his or her benefits can be suspended upon notification to the Bureau of Workers’ Compensation that the injured worker has returned to work.
Another situation in which an injured worker’s benefits can be suspended without the need to file a petition is if the injured worker fails to complete and return LIBC forms sent to them by the employer seeking verification of employment status or change in physical condition. The Pennsylvania Workers’ Compensation Act says that an injured worker is required to report “regularly” to the workers compensation insurance company the receipt of unemployment benefits, wages received in employment or self-employment, “old age” Social Security Retirement benefits, pension and severance benefits. Usually, the Workers’ Compensation insurance company will send the claimant a Verification Form (LIBC-750) asking these questions. An employer has a right to suspend benefits until the completed verification form is returned.
Other attempts to suspend benefits will involve the employer having to file a petition. If an injured worker fails to cooperate with vocational rehabilitation efforts, refused to be examined by a doctor, becomes incarcerated, or voluntarily withdraws from the labor market, the employer may suspend benefits.
However, the most common situations in which an employer may file a petition to suspend benefits are:
- if the employer offered the injured employee work that the employer believes is within the employee’s restrictions and the employee turned down the work, or
- if a labor market survey (LMS) was conducted and found that work is generally available to the worker in the workers’ pre-injury economy or usual employment area.
Frequently, these situations arise when there is a disagreement between the treating physicians and the IME physician concerning what work restrictions should govern the injured employee.
If the injured worker has refused employment which the employer feels is suitable, the issue usually becomes whether the worker can actually do the job that the employer has offered. The treating doctor’s testimony and the testimony of a vocational expert on this issue is very important.
If you receive an offer of employment by your employer and your physician does not believe you should accept this offer, you should contact an attorney immediately. If you are receiving benefits and the insurance company requests that you undergo an “independent medical examination” or hires a vocational expert to conduct a vocational interview, you should contact an attorney. Finally, if you receive a Petition to Terminate, Suspend or Modify your compensation benefits, you will need an attorney.
If you are referred modified employment which pays less than your pre-injury wages and do not respond to the referral, your employer may file a Petition to Modify your compensation benefits. Such a petition is similar to a suspension petition, but instead of a request for a full suspension of wage loss benefits, the employer seeks only a reduction in those benefits.
An injured worker is in danger of losing his workers’ compensation benefits completely if the employer feels the employee is no longer disabled and has fully recovered from the injury. In Pennsylvania, a Petition to Terminate Compensation Benefits is filed when an employer is alleging that the injured worker has fully recovered from the work-related injury. A termination petition is usually filed shortly after you are seen by a doctor for the purposes of conducting an IME, or “Independent Medical Examination.” For the Employer to file a Termination Petition, the IME doctor has to find that the Employee has made a full recovery from the work injury. If the IME doctor gives such an opinion, he or she will fill out an Affidavit of Full Recovery, stating that you are 100% fully recovered from the work-related injury. The defense attorney will then use this sworn Affidavit of Full Recovery, and the IME report, to file a termination petition. If a termination petition is granted, the workers loses all rights to workers’ comp benefits, including wage loss, along with any future medical treatment benefits.
In Pennsylvania, the Workers Compensation Act allows employers and insurance carriers to try to stop your workers comp benefits if they think that your work injury no longer requires medical treatment and no longer affects your ability to earn your average weekly wage. If you are still treating for your workers compensation injury and you are not earning the average weekly wage you earned before your injury, the workers’ compensation attorneys at McCormick & Vilushis can help you keep your benefits going while you continue treating. Call the experienced workers’ compensation attorneys at McCormick & Vilushis, LLC at (814) 455-5362.