How Can Workers Compensation Checks Stop?

Weekly workers compensation checks are one of the primary benefits provided by Georgia’s workers compensation law.  You can receive these checks for several different reasons:

1. When your injury keeps you from working.  These checks are called temporary total disability benefits.
2. If you are able to work but making less money because of your injury.  These checks are known as temporary partial disability benefits.
3. When your injury causes a permanent impairment.  These checks are called permanent partial disability benefits.

Each of these different types of workers compensation checks has their own rules.  Under Georgia law, the insurance company may have to pay them to you in certain situations.

But, the law also allows them to stop your checks when certain things happen.  Sometimes, the insurance company follows the law when they stop your checks.  Other times, they break the rules.  This article will provide some information about times when the insurance company can stop your checks and times when they cannot.

Should I receive some kind of notification when my check stops?

Yes.  The insurance company should send you a form notifying you that your check has stopped.  This form is called a Form WC-2.  The insurance company should  file this form to notify you when your checks start or stop.

When you receive the form WC-2, you should be able to identify why the insurance company stopped your check.  Section C of the Form WC-2 is entitled “Suspension of Benefits”.  It includes a number of different reasons why the insurance company might stop your check.

Some of the reasons that your check could be stopped include the following:

• You return to work without restrictions
• You return to work with restrictions but are making as much as you did before you got hurt (if you return to work with restrictions but are making less money you may be entitled to temporary partial disability benefits)
• The authorized treating physician has released you to return to work without restrictions
• The employer offered you a suitable job within your restrictions and you unjustifiably refused that job
• You reach the time limit for temporary total or temporary partial disability benefits
• Your entire permanent partial disability rating gets paid

What if my check stops and I do not receive a WC-2?

Sometimes, the insurance company stops paying you a check without a valid reason. They may just stop it or forget to pay it.

If that happens, then you or your attorney probably need to contact the insurance company.  The insurance company should not stop your check without a valid reason.

The insurance company should restart your check once they realize that they do not have a valid reason to stop it.  If they refuse to restart your check when they should be paying you, then you may have to either file a motion or request a hearing with a workers compensation judge. If you can prove in court that they weren’t entitled to stop your check, then you’ll probably get your check restarted, and you’ll probably get some late penalties as well.

Can I fight the reason the insurance company stops my check?

Yes.  There are at least three different ways that you can fight the reason that the insurance company stops your workers compensation check.

The insurance company did not file a Form WC-2

The first way is when the insurance company does not file the Form WC-2 when they stop your check.  In this situation, they have not followed the procedures established by Georgia’s workers compensation law.  You or your attorney can file a motion or request a hearing to try to get your check restarted.

The insurance company files a Form WC-2 but does not follow State Board rules

The second way you can fight the insurance company stopping your check is when the reason that the insurance company alleges on the Form WC-2 is not correct.  An example is when a doctor releases you to return to full duty work without restrictions.  There are certain rules the insurance company has to follow when stopping your check.

They have to give you appropriate advance notice that your check is going to stop.  They have to send you a copy of the full duty release from your authorized treating physician.  If they do not follow these rules, you or your attornye should be able to get your check restarted.

You disagree with the reason given on the Form WC-2

Sometimes, insurance companies follow the rules.  They send a Form WC-2 and meet all the other requirements of the Georgia State Board of Workers’ Compensation.

In this situation, you can still fight your check being stopped in many instances if you disagree with the reason that led to your check being stopped.  Let’s discuss an example:

Suppose you are still having pain and difficult from a back injury at work.  But, the workers compensation doctor still says you can go back to full duty work without restrictions.  In this situation, the insurance company might file a Form WC-2 and stop your weekly checks.

You have a right to fight the doctor’s opinion that you can go back to full duty work.  If the insurance company follows all the rules, you may have to go to court.  But, you or your attorney could present evidence in court to prove that you still have restrictions from your work injury.

If you want to learn more about how workers compensation court works, this article provides a short overview.