The Kentucky workers’ compensation system is designed to assist employees who are injured during the course of performing job-related activities. Workers’ compensation can be awarded in lump sum or in weekly payments. Unfortunately, however, if you are receiving weekly payments, your workers’ compensation payments can be cut off for a number of reasons (or excuses, as the case may be).

Reasons for Terminating Your Payments

Following are some of the most common reasons that might be asserted for cutting off your workers’ compensation payments:

1. Drugs or alcohol are thought to have contributed to your accident.
2. You are accused of “malingering” (faking your injury or exaggerating the extent of your disability.
3. You fail to follow your doctor’s orders, thereby contributing to your own disability.
4. Your employer offers you light duty work that is within your doctor’s work restrictions. If the salary is lower, you can seek compensation for the resulting lost earnings.
5. An Independent Medical Exam doctor hired by the insurance company disputes your claim, or you fail to show up for the exam;
6. You “fail” a Functional Capacity Exam, a test to determine the extent of your disability. Ironically, you “fail” this test by “passing” it — the better your performance, the more likely you are to be denied benefits. .
7. You quit your job during your time off work. Quitting your job will only reduce the amount of your lost earnings claim, not your medical expense claim.
8. You are awarded lifetime medical benefits and subsequently, there are suspicious gaps in your use of them. This may raise doubts about whether your disability is truly permanent.
9. A doctor concludes that you are able to return to work.
10. A doctor concludes that you have reached Maximum Medical Improvement (MMI). This determination could threaten any future payments for medical expenses.
11. The insurance company determines you were not injured on the job (that your injury occurred while you were off-duty, for example).
12. The insurance company’s doctor determines you had a pre-existing condition that caused the injury or that is responsible for your disability.

What to Do

You don’t always have to simply accept the decision to cut off your workers’ compensation benefits — you can fight back. Following are two of the most likely options:

Appeal

The notice you receive stating your benefits have been cut off will detail the appeal process. Once you appeal, a Benefit Review Conference with the workers’ compensation insurance company will be scheduled, and you can negotiate your claim with them (see below). If you cannot reach a settlement, a hearing will be scheduled in front of an Administrative Law Judge (ALJ). Bring an attorney, because this will be nothing like small claims court.

If you are not satisfied with the decision, you can file a “Petition for Reconsideration.” with the same ALJ. If you are still not satisfied, you can appeal to the Workers’ Compensation Board and, finally, to the Kentucky Court of Appeals. The further you proceed along the appeals process, however, the smaller your likelihood of success becomes.

Negotiate a Settlement

Most workers’ compensation disputes are resolved through negotiation. Remember, however, that the representatives of the insurance companies are likely to be professional negotiators. Let your workers’ compensation lawyer do the negotiating for you, and remember that any settlement must be approved by the Kentucky Department of Workers’ Claims.

Take Bold Action Today

If you workers’ compensation benefits have been cut off, contact Kentucky workers’ compensation lawyer Glenn Martin Hammond at (606) 437-7777, or fill out our online contact form, to schedule a free consultation. We charge nothing unless we win your claim.

We serve clients in Lexington, Pikeville, Winchester, Paris and elsewhere in the state of Kentucky.