When your Texas work injury is covered by workers’ compensation, four primary types of benefits are available: income benefits; medical benefits; burial benefits; and death benefits. Both income and death benefits are ongoing cash payments that may be received by the injured worker or by surviving dependents. However, while you and your family may be relying on these benefits, the law does not guarantee they will continue indefinitely.
An insurer may suspend or modify cash benefits after a work injury under certain circumstances. If the insurer believes you are no longer eligible for benefits or if the insurer believes your benefits should be reduced, the income you have coming in can be modified. If you object to the actions of the insurer, you have the legal right to dispute the change and go through the dispute procedure established by Texas workers’ compensation law. A Texas workers’ compensation lawyer can help you with the process of protecting the cash you need by appealing if benefits are changed.
When Can an Insurer Suspend or Modify Cash Benefits After a Work Injury?
An insurer can modify cash benefits after a work injury if you are cleared to return to work on a light duty capacity. Your disability income benefits are based on you being unable to work and/or having your earning potential reduced. If you are cleared to return to a job and you are able to go back to work and begin earning income, the insurer may modify cash benefits to account for the fact that you are no longer experiencing the full loss of wages due to work injury. If the light duty work you do is not paying as much as your job before getting hurt, you’ll still receive some workers’ comp disability benefits- but it will be a lesser amount.
An insurer can stop paying cash benefits after a work injury if you are cleared to go back to work and return to the job you had before you got hurt. Since there is no more wage loss, there is no more need for these benefits. The insurer can also stop paying benefits if you are terminated for cause from your employment. An employer cannot fire you to avoid workers’ comp payments, but if you are terminated for some other reason then there is no more need for the insurer to compensate you for your loss of wages due to your work injury.
If you are receiving temporary disability benefits, your benefits can also end when you have reached maximum medal improvement or when 104 weeks have passed from the eighth day after you became disabled. In week 105, you are no longer eligible for temporary disability income. If you remain disabled or impaired and unable to work due to your workplace injury, you may switch to receiving impairment income benefits instead of temporary disability benefits.
If your insurer decides to suspend or modify cash benefits after a work injury and you believe this decision was improper, contact the Texas workers’ compensation lawyers at Abbott and Associates, L.L.C. to help you fight the change that has caused you financial harm.