Workers’ Comp Benefits Stopped for No Reason? That May Be Against the Law.

We’ve seen and experienced our share of insurance horror stories – the deceptions by some companies, delay and deny tactics, even outright lies in some cases.

So it is not surprising to us when a client contacts us because they’ve been abruptly and for no apparent reason cut off from receiving medical treatment or cut off from their paychecks.

Unfortunately, this can be an all too typical scenario:

You’ve been hurt at work, and the insurance company has been paying for your medical treatment. Then, one day, your medical treatment stops. The doctor’s office calls to tell you that your appointments have been canceled and they will no longer have your prescriptions refilled.

Dumbfounded, you call the adjuster from the insurance company assigned to your case to find out what’s going on. She tells you, “We’ve closed your file.”

What gives? Can the insurance company do that? Can they just stop your medical treatment without your knowledge?

No. But that doesn’t mean some may not try to get away with it. Sadly, some do.

Your insurance company can't close your case because they don't want to pay for appointments or send checks.

The experienced workers’ comp attorneys at the Law Offices of James Scott Farrin are here to fight for you when an insurance company tries to take advantage of you and deny you the benefits you may potentially be owed. An insurance company may be banking on the fact that you don’t know they can’t do that.

Your Right to Medical Treatment as an Injured Worker

If the insurance company has accepted responsibility to pay for your injury, the law requires them to pay for the medical treatment recommended by your doctor. Sometimes, however, the doctor’s recommendations may be expensive and the insurance company may not want to pay. We have seen such circumstances in which the insurance company has canceled appointments outright, putting the onus on the injured worker to challenge them. (That is when many turn to us for help.)

But they don’t have the right to just cut you off. You have the right to get the medical treatment you need to heal so you can try to get back to work. Sometimes, you may be forced to consider hiring a workers’ compensation attorney to fight for you to protect that right.

For a free case evaluation, call 1-866-900-7078 or contact us online to discuss your case.

Your Right to Treatment May Extend 2 Years After You’re Declared “Healed”

Medical care might continue 2 more years even after doctor says nothing more to offer.

What we’ve seen happen to some injured workers is that when they contacted their insurance company within that two-year timeframe, they were told their case had been closed.

If that happens to you, you may have the right to go back to the doctor for up to two years after the last date the insurance company paid for any treatment.

Your Right to a Second Opinion

Injured workers also have the right to request a second opinion from another doctor. We typically urge our clients to take advantage of this opportunity. If the request is approved, a second opinion can help to try to make sure nothing has been missed and no other treatment is available that might help improve your condition.

The insurance company may try to ignore your request for a second opinion and try to tell you after your doctor releases you that your case is closed.

Your Right to Benefits Checks

Insurance companies can’t close your case because they’re tired of sending you a benefits check every week. In most circumstances, once the insurance company starts sending you a weekly benefits check, they must continue to send that check until you’ve returned to work or the insurance company has been given permission by the state to stop the checks.

Even then, you may have the right to start getting the benefits checks again if you have to go out of work. The insurance company may have to restart paying your claim even if they stopped your check once.

Can the Insurance Company Stop Paying Workers’ Comp Without Notice?

Unfortunately, some insurance companies may close your case and stop paying your workers’ comp benefits without notifying you, but they are supposed to get permission and inform you first. Your workers’ comp case can be closed if more than two years have passed from the time you either made the claim or benefits were last paid. This is the general statute of limitations in workers’ compensation cases. But the insurance company should not stop paying your workers’ comp benefits before they notify you.

Don’t fall victim to delay, deny, and defend tactics some insurance companies may use.

Workers’ Compensation Lawyers Offer FREE Case Evaluation

If you have any questions about your case being closed, we advise you to contact the Law Offices of James Scott Farrin.

The sooner you contact us after your job injury, the better. We can answer your workers’ comp questions about your situation. Any delay in contacting us could give your adjuster a chance to deny, delay, or stop benefits.

Based on our workers’ compensation team’s 250 years of combined experience, it is almost always a good idea to speak with us about your circumstances. Our confidential case evaluations are free, and you may learn that you’re entitled to more than the insurance company claims.

If you’ve been injured in a work accident or know someone who has, contact us today or call 1-866-900-7078 to learn how a workers’ compensation lawyer from the Law Offices of James Scott Farrin could potentially benefit you.

About the Author

Michael F. Roessler practices workers’ compensation law in North and South Carolina for the Law Offices of James Scott Farrin. Michael is among the less than 1% of attorneys licensed to practice in North Carolina who are North Carolina State Bar Board Certified Specialists in Workers’ Compensation law.a He has contributed several written pieces to legal publications, including the North Carolina Law Review, the Charlotte Law Review, and the Southwestern Law Review. He is a member of the North Carolina Advocates for Justice and the North Carolina Bar Association. In 2022, Michael was named to the “Best Lawyers”b list for Workers’ Compensation Law by Best Lawyers in America.

aFigures provided by the NC State Bar as of 2/21.

bFor more information regarding the standards for inclusion, please visit www.bestlawyers.com.