Boston Worker’s Compensation and Injury Blog

When do Workers’ Comp Benefits End?

Most businesses are required by law to provide workers’ comp benefits to injured workers. Whether you are already approved or not, you might wonder, “When do workers’ comp benefits end?”

After a workplace accident, what workers’ comp benefits you get and for how long depends on your particular injury and how it is categorized.

In this article, you will learn about different workers’ comp benefits and how long they might last.

How Long Will I Get Workers’ Comp Benefits?

The prospect of losing workers’ comp benefits before you can go back to work can be scary. So when do workers’ comp benefits end?

How long workers’ comp benefits will last varies from state to state. This could mean a certain number of weeks or lifetime benefits. This length of time is decided according to the category assigned to the injury in question, including:

  • Permanent Partial Disability
  • Permanent Total Disability
  • Temporary Partial Disability
  • Temporary Total Disability

Let’s have a closer look at these disability categories and how workers’ comp benefits apply to them.

Permanent Partial Disability

Permanent partial disability (PPD) refers to an injury or illness that is disabling but only to a certain extent. Someone with a permanent partial disability will still be able to perform workplace duties, but not all of them. Injured workers in this category might also be able to perform all of their previous functions but far from 100% capacity like before.

For example, an employee who injures his/her leg can no longer bend over to pick up items like before.

The term “Permanent” here can be confusing since these benefits can be limited to 425 weeks or less.

Some of the workplace injuries that fall into this category include:

  • Carpal tunnel syndrome
  • Hearing loss
  • Nerve damage
  • Loss of vision in one eye
  • Loss of one finger or hand
  • Post-traumatic stress disorder (PTSD)

Permanent Total Disability

An employee’s injuries can be categorized as permanent total disability (PTD) if he/she cannot go back to work or has sustained severe injuries to two main body parts. For example, injured employees who can no longer use both arms after a workplace accident fall under this disability category.

Permanent total disability usually qualifies injured employees for workers’ comp benefits for the rest of their lives if their situation does not change.

Temporary Partial Disability

Temporary partial disability benefits (TPD) are for injured workers who are recovering but still working in a lesser capacity than before.

Usually, injured workers in this category will receive two-thirds of the difference between their current and pre-accident wages. For example, if you are now making $2,000 a month but used to make $3,500, you will receive $1,000 in benefits.

These benefits will go on until it is determined that the employee has reached maximum medical improvement (MMI). This is when the worker has recovered as much as possible.

Temporary Total Disability

Some workplace injuries are so severe that employees cannot return to work in any capacity at all. While recovering, injured workers in this category may receive temporary total disability (TTD) benefits which will last until they fully recover or reach MMI.

Reasons why Workers’ Comp Benefits Come to an End

In a perfect world, insurance companies would be willing to extend workers’ comp benefits to injured workers as long as necessary. But that is not always the case. These companies are in the business of making money, after all.

Some common reasons that lead to the termination of workers’ comp benefits include:

  • Failing to get a required medical examination
  • Not following a recommended treatment plan
  • A judicial decision
  • Voluntarily giving benefits up

Failing to Get a Required Medical Examination

You may be required to get an independent medical examination (IME) to determine the severity of your injuries and the proper course of action.

Failing to comply with an IME can lead to initial benefits being denied or terminated if you already have them.

Not Following a Recommended Treatment Plan

Once an authorized medical professional has diagnosed your injuries, a treatment plan will be recommended to help you recover. Failing to comply with this treatment plan can lead to a suspension of any workers’ compensation benefits you are receiving.

A Judicial Decision

Insurance companies are notorious for their pursuit to avoid paying benefits, including those from workers’ compensation. Your employer’s insurer might claim that you are no longer eligible for these benefits for one of many possible reasons, and a judge could agree to end them.

Voluntarily Giving up Benefits

Believe it or not, some injured workers end up signing their workers’ compensation benefits away before making a full recovery. This can be due to pressure from their employer, the insurance company, or the false belief that they are in good enough health to go back to work.

Having proper legal representation can help you avoid this.

Will My Workers’ Comp Benefits Stop Suddenly?

Your workers’ comp benefits will not stop from one day to the next. There are legal procedures in place to terminate these benefits. You can expect the following:

  • You will receive notification from your employer’s insurance company about their intent to end your worker’s comp benefits.
  • A specific reason for the termination of your benefits should be stated in the notification.
  • A date when your benefits might come to an end if that decision is made.

What to Do When Workers’ Comp Benefits are Threatened

If you are notified that your workers’ compensation benefits might come to an end, and you strongly believe it would be an unjust decision, you should contact an attorney immediately.

You might think that you can successfully fight an insurance company on your own or even convince them about the right thing to do, but that is rarely the case. Remember that these companies are out to make money. They will go out of their way to avoid paying workers’ comp benefits whenever they can.

A lawyer who specializes in workers’ comp cases knows how to deal with insurance companies and get you the best possible results depending on the facts of your case.

Get a Free Consultation

When workers’ comp benefits end depends on your injury and how it is categorized. In most cases, the decision to end these benefits is made justifiably, but not always.

If you feel that your workers’ compensation benefits are being unjustly threatened or have already been terminated without cause, you need a lawyer.

Legal representation is essential to getting a favorable decision in a workers’ compensation case.

Call us at the Law Office of Robert E Frawley at (617) 523-2929 and we’ll help you get the compensation you deserve.

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