- Workers' Compensation
Workers’ compensation is an essential provision for employees who have sustained injuries or illnesses while performing their job duties. However, it’s not an indefinite arrangement. There are specific circumstances under which these benefits may cease. This article aims to provide a more detailed understanding of these situations.
Workers’ compensation is a form of insurance that provides medical benefits and lost earnings to employees injured on the job. When an injured employee files a workers’ compensation claim, the insurance company covers medical expenses and a portion of lost wages. Situations that qualify for workers’ compensation include any work-related injury or illness, provided the employee is physically capable of returning to work. Workers’ compensation stops when the employee fully recovers, reaches maximum medical improvement, or fails to comply with medical treatments.
Our workers comp lawyers help employees in Miami, Coral Springs, and across Florida. Contact us today for a free case review.
When Does Workers Compensation Stop?
According to Florida Statutes § 440.20, workers’ compensation income benefits do not begin until you miss eight days of work. You do not get paid for the first week you miss work unless you miss 21 days or more.
There are several situations that can cause your workers’ compensation benefits to end.
Settlement
A workers’ compensation settlement is an agreement between an injured employee, the employer, and the workers’ compensation insurance company to resolve a claim. After a work injury, the insurance company covers medical treatment and lost wages. With the help of a workers’ compensation attorney, the injured employee negotiates a lump sum or structured payment with the workers’ compensation insurance carrier. This settlement finalizes the claim, potentially ending future benefits from the workers’ compensation insurance.
If both you and the insurance company decide to stop the payments, it often involves a settlement. You might receive a one-time payment or structured payments, but you’ll have to give up your right to ongoing weekly benefits.
Court Order
A judge specializing in workers’ compensation cases can order the stoppage of payments if they determine that you’re no longer eligible for benefits. This could be due to evidence of recovery from the injury, or findings of fraud or misrepresentation.
A court order to stop workers’ compensation benefits typically occurs when an injured worker is deemed to have reached maximum medical improvement (MMI). At this point, a workers’ compensation lawyer may argue that further benefits are unnecessary. The court evaluates the medical evidence and, if it agrees that the injured worker no longer needs ongoing support, issues an order to stop benefits. This decision affects the payment of medical bills and other benefits previously provided, effectively stopping benefits as the worker’s condition stabilizes.
Back to Work
If you’ve healed from your injury and have resumed work, your benefits may stop. Workers’ compensation is meant to cover lost wages due to a work-related injury. Once you’re back at work, these benefits usually end.
Termination of Workers Compensation Benefits
If you don’t comply with medical treatments, your workers compensation benefits can be terminated.
- Refusal of a Medical Examination: If you refuse an order for a medical examination, it could be grounds for termination of benefits.
- Refusal of Treatment: If you refuse reasonable medical treatment, it could lead to termination of benefits.
- Criminal Conviction: Your benefits may be terminated if you are convicted of a crime and imprisoned.
- Non-compliance with Verification Requirements: If you fail to return the employment verification form to the insurer within 30 days, your benefits may be discontinued.
In all these situations, you will receive a notification informing you about the termination of weekly payments. It’s imperative to contact a workers’ compensation lawyer if your benefits are in jeopardy.
In disputes regarding benefits, workers’ compensation judges oversee the proceedings. Your employer or its insurance company must present evidence demonstrating that there is a valid reason for terminating your benefits.
An experienced workers comp lawyer can stand up for your rights and represent you in court if necessary.
Time Limits on Workers’ Compensation Benefits
In Florida, workers’ compensation benefits are subject to certain time restrictions, varying based on the type and severity of the injury.
Different Kinds of Workers’ Compensation Disability Benefits:
- Temporary Total Disability (TTD): For those temporarily unable to work.
- Temporary Partial Disability (TPD): For those who can do limited work temporarily.
- Permanent Total Disability (PTD): For those who are permanently and completely unable to work due to severe injury or illness.
- Permanent Partial Disability (PPD): For those who have permanently lost some ability to work.
Duration of Benefits:
- Temporary disability benefits can be received for up to 104 weeks. If you reach maximum medical improvement (MMI), your TTD benefits will cease, even if 104 weeks have not passed. MMI is when no further treatment will improve your condition, as declared by your doctor.
- If you have a permanent partial disability, your doctor will assign an impairment rating when you reach MMI, which determines the number of weeks of benefits you can receive.
- Permanent total disability benefits continue until you turn 75 or there’s proof that you can return to work.
- Medical care coverage for your injury and related issues can last a lifetime or until a lump-sum payout settlement is reached with the insurer.
Understanding when and why workers’ comp might cease is crucial for employees. If you’re uncertain about your situation or if your payments have unexpectedly stopped, it’s recommended to consult with a workers’ comp lawyer immediately.
Contact Us for a Free Case Review!
At Work Injury Rights, we can help you understand how long your workers’ compensation benefits should last and help you throughout the entire claims process. If you’re unsure if you qualify or have questions, we can assist you.
Our lawyers have a combined 45 years of experience in Florida workers’ compensation law. Contact us at 954-388-8616 today.
