Workers’ compensation insurers have to follow specific procedures to lawfully terminate or to reduce Florida workers’ compensation benefits. The process for modifying or terminating benefits varies based on how long the benefits have been being paid.
180 or Fewer Days after the Disability Begins
If the insurer has started to make payments of weekly benefits within 14 days of a notice, the insurer can stop the payments to the worker without gaining approval from any party or having to acquire consent from the employee. However, it is required that the insurer provide the employee a seven day written notice of their intent to cease benefits.
The written notice related to termination has to state the reasons why and advise of the rights the employee has to claim additional benefits. If you are returning to work for the same pay rate you earned prior to the accident, then the insurer can terminate the benefit as of the last day you were considered disabled. If a treating doctor has cleared the worker to go back to work, the insurer can terminate the benefits regardless of if the job is still available.
Past 180 Days
After a period of 180 has passed, the Workers’ Compensation Act has made it more challenging for an insurer to terminate the benefits. Essentially, they are unable to stop paying the benefits on their own. The reason to cease payments has to be specific and be one of the following:
- A judge ordered the termination of benefits
- It was assented to in writing by the worker
- The worker went back to their job at the same wage they had when they left
- The insurer received a report from the worker’s physician indicating they could return to work with the certification that the doctor reviewed the job description of the employee and the insurer has received a letter from the employer stating the job is waiting for them
- The employee reached the maximum amount of time to receive benefits
- Termination occurred because the employee didn’t provide the insurer with a request in writing for earning records
- Other specific and technical reasons
The most important takeaway is that after a period of 180 days has passed, the insurer is unable to stop paying benefits on a whim and they have the ability to do that (in some instances) before the 180th day is reached.
When to Contact an Attorney
If you have had your benefits terminated by a workers’ compensation insurer, you need to contact a workers’ compensation lawyer right away to discuss how you can get your benefits reinstated. There are several laws that insurance companies have to follow to have benefits terminated.
If you need help, or have questions, contact workers’ compensation attorney Scott J. Sternberg by calling 561-687-5660. The attorneys can discuss your options and help to protect your rights. There is no reason to have your benefits terminated if you still deserve to receive them and with an attorney, you can take the proper steps to have benefits reinstated.