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

By Michael F. Roessler

We’ve seen and experienced our share of insurance horror stories – the deceptions, delay and deny tactics, even outright lies in some cases. So many in fact that we developed a book called Insurance Companies (and Others) Behaving Badly.Insurance Companies (and Others) Behaving Badly

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 they won’t try.

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. We suspect some insurance companies are banking on the fact that you don’t know they can’t do that.

Your insurance company cannot close your case just because they no longer want to pay for doctor appointments or send you regular checks.

But just like other types of infractions, that does not stop them from trying to get away with it. Sadly, some do.

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 hire an attorney to fight for you to protect that right.

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

If an insurance company tries to deny you medical treatment, the attorneys at the Law Offices of James Scott Farrin can request that a workers’ compensation judge order the insurance company to pay for the treatment you need to try to get better.

Depending on the facts of your case, you may also have a right to get medical treatment for your work injury up to two years after your last doctor’s visit. This is important to know because even though you and your doctor may initially think you are fully healed from a work injury your condition might worsen over time. We see this happen a lot.

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.

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.

Your right to medical care might continue for two more years even after your treating doctor says he has nothing more to offer.

Your Right to a Second Opinion

Injured workers like you 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 all 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 North Carolina Industrial Commission 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 can’t close your case just because they stopped your check once.

Can Your Workers’ Comp Case be Closed Without Your Knowledge?

The only time your case can be closed without your knowledge is when more than two years has passed from the time you either made the claim or benefits were last paid. This is the statute of limitations in workers’ compensation cases.

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

NC Workers’ Compensation Lawyers Offer FREE Case Evaluation

If you have questions about whether your case has been closed for any reason, 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 try to answer your questions about your situation. Any delay in contacting us could give your adjuster a chance to deny, delay, or potentially stop benefits.

Based on our team’s 150 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.

Michael Roessler joined the Law Offices of James Scott Farrin in 2015, handling workers’ compensation cases. Prior to joining the firm, Mr. Roessler represented personal injury and workers’ compensation clients for more than five years. He is an adjunct professor of Political Science at Queens University of Charlotte, where he has taught pre-law since 2010.

Mr. Roessler earned his J.D., with honors, from the University of North Carolina School of Law at Chapel Hill and a B. A. from Queens University of Charlotte, where he double majored in History and Political Science.

In law school, Mr. Roessler received numerous awards and honors. He was selected to join both regional and national Holderness Moot Court teams and the Broun National Trial Team, where he and his team were national quarterfinalists.

Originally Mr. Roessler set out to pursue a journalism career. He wrote multiple news articles and opinion columns for the Mooresville Tribune (NC) and the Independent Tribune (Concord-Kannapolis, NC). However, after befriending some local attorneys who were advocating for the more marginalized members of his community, he realized his passion lay with those members of society. Soon after, he enrolled in law school and became an attorney in an effort to help advocate for those individuals’ rights.

Contact Information

Raleigh Law Office

5848-100 Faringdon Place
Raleigh, NC 27609
Phone: 919-834-1184
Toll Free: 1-866-900-7078

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280 South Mangum Street, Suite 400
Durham, NC 27701
Phone: 919-688-4991
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Fayetteville, NC 28304
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Charlotte, NC 28203
Phone: 704-599-1078
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New Bern, NC 28562
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702 G Cromwell Dr.
Greenville, NC 27858
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Greensboro, North Carolina 27401
Phone: 336-665-7072
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214 South William Street, Suite 3
Goldsboro, NC 27530
Phone: (919)-731-2581
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Henderson, NC 27536
Phone: 252-492-4600
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709 Julian R. Allsbrook Highway
Roanoke Rapids, NC 27870
Phone: 252-537-9670
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3202 Sunset Avenue, Suite B
Rocky Mount, NC 27804
Phone: 252-937-4730
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703-B South Horner Boulevard
Sanford, NC 27330
Phone: 919-775-1564
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2315 Airport Blvd Suite A
Wilson, North Carolina 27896
Phone: 252-246-9090
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301 N. Main Street, Suite 2409-C
Winston-Salem, NC 27101
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