Dealing with a work injury is hard enough. You’re trying to heal, going to doctor appointments, and dealing with pain or other limitations. On top of all that, you have to worry about how you will pay your bills.
Workers’ compensation benefits are designed to provide a safety net during this difficult time.
They are meant to cover your medical costs and replace a portion of your wages while you recover.
But what happens if your workers’ comp benefits are cut off? Suddenly, that safety net feels like it has a big hole in it. You might get a letter from the insurance company, or your payments might just stop showing up. This can leave you wondering about your future.
There are specific reasons why your workers’ compensation benefits might be terminated. Knowing those reasons and your rights can make all the difference. Our experienced Montgomery workers’ compensation lawyer can walk you through all the different situations that could cause your benefits to be terminated.
Types of Workers’ Comp Benefits Available in Alabama
In Alabama, workers’ compensation provides several types of benefits to employees injured on the job:
1. Medical Benefits
These cover all medical expenses related to your work injury, including doctor visits, hospital stays, prescriptions, physical therapy, and medical equipment. Generally, these benefits continue as long as you need medical treatment for your injury.
2. Temporary Disability Benefits
These payments help replace a portion of your lost wages while you are temporarily unable to work. They are a percentage of your average weekly wage.
3. Permanent Disability Benefits
If your injury causes a lasting impairment, you may receive these payments after your temporary benefits have ended. They are meant to compensate for your permanent loss of earning capacity.
Time Limits on Temporary Disability Payments
Temporary disability payments in Alabama are not indefinite. They are meant to help you while you are recovering and cannot work. The payments will stop when one of two things happens.
The first is when you can return to your job. Even if you come back with some restrictions, your temporary disability payments will likely end.
The second is when a doctor decides you have reached “Maximum Medical Improvement” (MMI). This means your condition has stabilized, and no more medical treatment will improve it. At that point, your temporary benefits will stop, and your claim may move to the next stage, which is determining if you have a permanent disability.
When Does Workers’ Comp Stop Paying You?
If you have a lasting impairment after your temporary benefits end, you may be eligible for permanent disability benefits. Your doctor will decide when your condition has reached MMI. This is when permanent benefits usually begin.
Permanent disability payments can be for a partial or total disability. Permanent partial disability (PPD) is for those who can still work but have a lasting impairment. The amount you receive is based on your injury and how it affects your ability to earn a living. The payments for PPD are typically limited to a certain number of weeks.
Permanent total disability (PTD) is for workers who are considered completely and permanently unable to work again. These payments can continue for as long as you remain totally disabled, which may be for the rest of your life. However, these payments could stop if your condition improves and you can return to work.
Reasons Workers’ Comp Payments May Be Terminated
There are several reasons why your workers’ compensation benefits may be terminated before you expect them to be. The most common reasons include:
- You returned to work. If you can go back to your job, your benefits will stop.
- You failed to follow medical advice. If you do not attend doctor appointments or fail to participate in recommended treatment, the insurance company may stop your payments.
- The insurer disputes your claim. The insurance company might claim your injury is not work-related or that you have recovered and can go back to work.
- You settled. If you agree to a lump-sum settlement, your weekly payments will stop once the settlement is finalized.
- You failed to attend an Independent Medical Examination (IME). The insurance company has the right to request an IME by a doctor of its choosing. If you do not attend, your benefits can be suspended.
What Happens When Workers’ Comp Stops Paying
If your workers’ compensation benefits have been terminated and you believe the decision is incorrect, you have the right to challenge it. The appeal process can be complicated, and it is often a good idea to work with an attorney who knows Alabama workers’ compensation law.
Here are the general steps to follow if your benefits are terminated early:
Understand the Reason for the Termination
You should receive a letter or notice that explains why your payments were stopped. This letter will be important for your appeal.
Gather Evidence
To challenge the decision, you will need to collect documents that support your claim. This includes all of your medical records, doctor’s notes, prescriptions, and any correspondence you have had with your employer or the insurance company. If you have statements from witnesses or photos of the accident scene, those can also be helpful.
Act Quickly
There are important deadlines for filing an appeal. Generally, you have a limited amount of time to take action after your benefits are terminated. Missing these deadlines can cause you to lose your right to benefits.
File an Appeal
In Alabama, appealing a workers’ compensation termination means filing a lawsuit against the employer or their insurance carrier in civil court. This legal action is how you formally dispute the decision.
Prepare for a Hearing
If your case goes to a hearing, you will need to present your case to a judge. This means organizing your evidence and being ready to explain why you should continue to receive benefits. An attorney can help you prepare for this hearing and represent you.
The process of reinstating your benefits can be lengthy. An experienced lawyer can help you gather the right evidence, handle all the paperwork, and represent you in discussions with the insurance company or in court.
Contact an Experienced Montgomery Workers’ Compensation Lawyer
Workers’ compensation rules are complex, and insurance companies often try to limit how much they pay. If you are worried about when workers’ comp stops paying you or if your benefits were ended unexpectedly, you should seek legal help right away.
The lawyers at Hunter | Everage are well-versed in the intricacies of Alabama workers’ compensation law. We can help you understand your rights, protect your benefits, and make sure you receive the support you need. Contact our Montgomery office at 704-377-9157 for a consultation and find out how we can help you.