TERMINATION, MODIFICATION, SUSPENSION – OH MY!
If you have been injured on the job and the insurance company has accepted your claim, you are entitled to receive wage loss and/or medical benefits. In theory, those benefits could continue indefinitely. But absent extreme circumstances, no one stays on workers’ compensation forever.
The insurance company won’t let a claim proceed without taking steps to limit their exposure. The adjuster handling the claim probably marks the calendar to analyze your claim every 3-6 months. At that point, he/she will look for opportunities to limit your benefits.
There are three Petitions that the insurance company can use to try and change your benefit status:
Termination Petition – this Petition can only be filed if the insurance company has proof that all disability related to your injury has ended. Most often, this Petition will be filed after you attend an independent medical examination and that doctor concluded that you have “fully recovered” from your work injury. A termination of benefits is extreme because it means that all benefits (wage loss and medical) will end.
Modification Petition – this Petition can be filed if the insurance carrier has proof that you have the ability to earn wages, but not equivalent to the amount you earned before the work injury. In other words, they want to reduce the amount they are paying you. A Modification Petition only impacts your entitlement to wage loss benefits – it will have no impact on your right to continue with medical treatment.
Suspension Petition – this Petition can be filed if the insurance carrier has proof that you have the ability to earn as much as you did before the injury. This Petition usually comes after your employer has invited you to return to work, or after a vocational campaign (called a Labor Market Survey) has identified alternative work that could yield earnings equivalent to your pre-injury wages. A Suspension Petition only impacts your entitlement to wage loss benefits – it will have no impact on your right to continue with medical treatment.
Even though a Petition has been filed, the insurance carrier must still PROVE what has been alleged. The Petition will be assigned to a Judge who will review the evidence and, ultimately, issue a Decision.
Litigating one of these Petitions is complicated and you absolutely need a lawyer to represent your interests and protect your right to ongoing benefits. If one of these Petitions has been filed against you, contact Gross Law Office right away to schedule a free consultation.
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