After being approved for workers' compensation benefits, there is still a possibility that your benefits will not be fully paid. It is possible for the insurance company to end your benefits. If this happens, you could be left without the financial and medical support that you need. If you are on workers' comp, here is what you need to know.
Why Would the Insurance Company Stop Your Benefits?
There are several possible reasons that an insurance company could end your benefits. For instance, if the company requested a medical exam and you did not complete it, it is possible to stop benefits. In addition to this, your benefits could be ended under the following circumstances:
You refuse to return to work after being cleared by a doctor
A judge reviewed your case and approved the cessation of benefits
Your partial disability payment period has ended
You settle for a lump sum payment
You fail to complete the treatment recommended by your doctor
There are many other reasons that could lead to the insurance company's decision. The company is legally required to provide you with a denial letter. The reason for the change to your benefits should be documented in the letter. If not, contact the company and request information.
What Can You Do?
The options available to you depends largely on the reason for the denial. If the insurance company was justified in its reasoning, you could face difficulties in getting the decision overturned. In some situations though, it is possible to negotiate with the insurance company to reinstate the benefits.
For instance, if your benefits were ended because you did not undergo a requested medical exam, you might be able to convince the company to reinstate your benefits if you have the examination completed.
If the benefits were ended because there was a disagreement about whether or not you had an injury that impacted your ability to work, you can file an appeal and ask for another medical examination from an unbiased doctor.
You can even file a dispute with your state's workers' compensation commission. The case will be reviewed and a determination will be made regarding your rights to continue to receive benefits.
Contact a workers' compensation attorney as soon as you receive notice that your benefits have ended. The attorney can review the reasoning for the termination and help determine what your legal options are for fighting the insurance company's decision.