Louisiana Termination of Workers’ Compensation Benefits Lawyer
When you are injured on the job, workers’ compensation benefits in Louisiana are often necessary and crucial for you to recover without worrying about any financial hardships. These benefits help cover the cost of medical expenses and lost wages while you are recovering. But what happens when the benefits get terminated before you have fully healed and are able to return to work? Or what if you are permanently disabled and your benefits get terminated?
These are understandable concerns that many injured workers have when receiving workers’ compensation benefits. Unfortunately, it is not uncommon for benefits to get terminated by the employer’s insurance company. In many cases, the insurance company is lawfully allowed to terminate your benefits without approval from the Lousiana Office of Workers’ Compensation Administration (OWCA) or the Louisiana Workforce Commission (LWC).
This can be a scary situation to be in, as you might still be receiving expensive medical treatment and care for your injury or illness. Termination of benefits can leave you without a way to pay for your medical care or to cover your lost wages while you are unable to work.
If you find yourself in this situation, it’s important for you to get in contact with an experienced Louisiana workers’ compensation attorney. They can review your case and work with you to ensure your benefits are uninterrupted. If they do get terminated, your attorney may even be able to help you challenge the termination.
The Louisiana workers’ compensation lawyers at Lunsford, Baskin, & Priebe, PLLC can help if you are concerned about the termination of your benefits. Our lawyers represent clients across various industries and know what it takes to help them get the benefits they deserve. Learn more about what to do if your Louisiana workers’ compensation benefits get terminated below, and contact Lunsford, Baskin, & Priebe, PLLC, with any questions or concerns.
Reasons Workers’ Compensation Benefits Get Terminated
Many employers and insurance companies prioritize making money over the care and wellbeing of their workers. When workers’ compensation benefits get denied or terminated, it is often because the employer or insurance company doesn’t believe the workers’ injuries are that bad or that they no longer require medical treatment. Unfortunately, they do not need permission from the OWCA or the LWC to terminate benefits if they think you are able to return to work.
In some cases, your employer or their insurance may base their decision on the results of an examination or a statement made by a doctor that doesn’t fully know or understand the extent of your injuries. If the doctor makes it seem as though you are okay and potentially able to return to work, your benefits may get terminated. Unfortunately, the results of these limited examinations or basic statements are often not entirely accurate of an injured worker’s physical condition.
Even if your own treating physician does not think you are well enough to return to work, if the second opinion obtained by the insurance company says differently, they will likely terminate your benefits.
In other cases, benefits may get terminated because your medical condition has changed. For example, if you were on Temporary Total Disability benefits but your condition worsened, and you are now more permanently disabled, you would need to switch to another type, such as Permanent Total Disability benefits. If you do not report your change in condition and apply for new benefits, your original benefits could get terminated.
You could also have your benefits terminated if you fail to show up for medical appointments or refuse to undergo reasonable recommended treatments. When you are receiving benefits, you must show that you are making every effort to get better. If your employer thinks you are purposely delaying your treatments to extend your time off of work, they could terminate your benefits.
To sum up, workers’ compensation benefits can get terminated if:
- A doctor has cleared you to work (even if it is not your treating physician)
- Your employer or their insurance company doesn’t believe your injuries are severe or because they think you no longer require treatment (even if they are severe and you do still need treatment)
- You miss medical appointments
- You refuse reasonable treatments
- Your medical condition changes, and you do not apply for a new type of benefits.
- The insurance company believes you have provided false information or are faking the severity of your injury.
You can also have your benefits denied or terminated if you fill out the wrong form, make any mistakes on the forms you did file, or fail to file a form on time. Your benefits may also get terminated if you get arrested and go to prison.
It is crucial for injured workers to listen to their treating physicians and follow all of their recommendations for treatment. If you genuinely still need treatment and are unable to return to work, you have a right to continue receiving benefits. However, if you stop going to your doctor and refuse medical treatments that are necessary to help you get better, your benefits may get terminated.
If you have questions or concerns about your benefits and the treatments you are receiving, you should reach out to a workers’ compensation attorney. They can offer you guidance and support and let you know what decisions you need to make to continue receiving your medical and lost wages benefits.
What to Do if Your Workers’ Compensation Benefits Get Terminated
If you are concerned that your benefits may get terminated, you should take action before this happens. Waiting until your benefits have already been terminated can result in a gap in your benefits being paid. However, if you contact an attorney who can offer you immediate help, they may be able to help you take steps to avoid the termination of benefits in the first place.
Insurance companies will be less likely to terminate your benefits if they know you have an attorney advocating for your rights. Employers and insurers often terminate benefits hoping that the injured worker will be confused and not know what to do to continue receiving benefits. With an attorney, you can avoid this from happening.
If your benefits do get terminated, you have options. These include:
- Negotiate for a reinstatement of your benefits with the insurance company.
- Request an Independent Medical Exam (IME). This is a third medical opinion offered by a doctor appointed by the court.
- File a dispute claim with the Office of Workers’ Compensation Administration.
- Collect further medical evidence to support your need for continued benefits.
- Return to work, but in a limited capacity, so your employer can more accurately assess your needs and limitations.
The options that you will specifically need to take will vary depending on your individual situation. It’s always best to consult with an attorney to determine the best course of action.
At Lunsford, Baskin, & Priebe, PLLC, our Louisiana workers’ compensation attorneys can help you navigate the process of arguing against the termination of your benefits. This process can be scary and intimidating, but we are here to support you and advocate for your rights.
How to Challenge Workers’ Comp Benefits Termination
Workers’ compensation insurance companies are required to inform the injured workers of their termination of benefits by sending them a 1003 Stop Payment Form. They must also complete Form LWC-WC 1002 and send this completed form to the injured worker. If you wish to dispute the termination once you receive these forms, you will have to take the following steps:
- You must complete the Notice of Disagreement portion of the Form 1002 that was sent to you and return it to the insurance company.
- After the insurance company receives the returned Form 1002, they have seven days to decide if they wish to agree and continue paying the benefits.
- If the insurance company refuses to make a decision and pay within seven days, you will need to file a new Disputed Claim for Compensation Form 1008 and send it to the Louisiana Office of Workers’ Compensation court.
- After you file Form 1008, the insurance company may request a preliminary hearing with a workers’ compensation judge in response.
- If the insurance company fails to request a preliminary hearing, then your disputed claim will be scheduled for a trial.
- If a preliminary hearing is held, all parties will be allowed to introduce evidence to support their claim—including medical records, doctor statements, and witness testimony. The judge will then have 30 days to issue a recommendation.
- After the judge has issued their decision, the insurance company will have ten days to respond. They can notify the injured worker that they do not accept the decision or that they accept and comply. If they accept, they will be required to mail a Form 1002 to the injured worker along with benefits that are owed.
- If the insurance company does not accept the determination from the preliminary hearing, then the injured worker’s disputed claim will be scheduled for trial.
This process can be long and stressful. It can be difficult for injured workers to deal with this on their own. If you need to dispute the termination of your benefits, you should consult with an experienced Louisiana workers’ compensation attorney.
An Experienced Louisiana Workers’ Compensation Attorney Can Help
You have a right as an injured worker to continue receiving the benefits needed to cover your medical expenses and loss of wages. If you have concerns about them being terminated, our skilled and compassionate team of workers’ compensation attorneys can offer you guidance and support during this difficult time.