Why Did My Workers Compensation Checks Stop?

Why Did My Workers Compensation Checks Stop?

One of the most alarming things an injured worker can experience is opening the mailbox or logging onto their bank account and discovering that their workers’ compensation checks have stopped. Naturally, the first question is: “Can they do that?”

The answer is: sometimes yes, sometimes no.

Most injured workers asking this question are referring to Temporary Total Disability (TTD) benefits. These are the weekly checks paid when an authorized treating physician has taken you completely off work because of a compensable job injury, or given you physical restrictions which your employer cannot accommodate, but ttd benefits do not continue forever. Under Alabama law, there are several situations in which they may properly stop.

Reason #1: You Returned to Work

The most common reason TTD benefits stop is because the authorized treating physician has released you to return to work-either at full duty or with certain physical restrictions which your employer states they can accommodate-and you have returned to work. If you are earning wages again, the insurance carrier generally has no obligation to continue paying temporary total disability benefits; however, if you return to work earning substantially less than before your injury, you may be entitled to Temporary Partial Disability (TPD) benefits.

Reason #2: You Reached Maximum Medical Improvement (MMI)

Another common reason benefits stop is because your authorized treating physician has determined that you have reached Maximum Medical Improvement (MMI).

MMI means your condition has improved as much as it is expected to improve with medical treatment. Once you reach MMI, temporary benefits typically end and the focus shifts to permanent disability benefits, impairment ratings, permanent physical limitations and possible settlement discussions.

Reason #3: A Dispute Has Developed

In some cases, the insurance carrier may dispute:

• whether the injury remains work-related (do they now believe your symptoms are from a pre-existing condition or have you suffered a separate non-work related injury-called a subsequent intervening event
• whether ongoing disability exists
• whether additional treatment is reasonably necessary

When disputes arise, benefits are sometimes suspended pending resolution of the issue.

Reason #4: Missed Medical Appointments

Alabama Code §25-5-77(b) states “If the injured employee refuses to comply with reasonable request for examination, or refused to accept the medical service or physical rehabilitation, which the employer elects to furnish under this chapter, the employee’s right to compensation shall be suspended and no compensation shall be payable for the period of the refusal.”

Repeatedly missing appointments with your authorized treating physician or physical therapy can create problems in a workers’ compensation claim, and insurance carriers may argue that treatment has been abandoned or that there is insufficient medical evidence to continue paying benefits.

If, for some reason, you are unable to make it to an authorized visit for medical care, you should: (1) notify the medical provider once you know you will be unable to make it to your appointment; (2) notify the adjuster to let them know that you will be unable to make it to your appoint and the reasons why; (3) make a note of the date/time you informed your medical provider that you would be unable to attend an appointment and (4) continue following the previously approved treatment plan.

What Should You Do If Your Checks Stop?

First, do not panic; rather, try to determine (i) when your checks were stopped and (ii) the reason for the checks being cut off. Sometimes the explanation is legitimate. Sometimes it is not.

Workers’ compensation checks do not stop simply because an insurance carrier decides it no longer wants to pay them (or they are not supposed to). There is usually a reason for the change. Understanding that reason is the first step toward protecting your rights and ensuring that you receive any benefits to which you remain entitled.

If you have suffered a job injury and you have questions about your rights and benefits under Alabama’s workers compensation laws -don’t hesitate to contact and speak with one of the experienced Alabama Workers Compensation and Social Security Disability attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

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