The concern about continuing to receive a weekly check is something we see often, and understandably so. When you are out of work due to a work injury, your only source of income is often that weekly benefits check, and it's important to protect it while you're recovering from your work injury.
The insurance company cannot decide to just stop your weekly check if you don't go back to work. However, like most large and powerful bureaucratic processes, the devil is in the details.
When the Insurance Company CAN Stop Paying Benefits
In North Carolina, once your weekly checks start, the insurance company can only stop paying them under two circumstances:
- You return to work
- The insurance company gets permission from the Industrial Commission to stop paying
If you go back to work, even for a day, the insurance company can stop your weekly check immediately, without going before a judge. If you are, for any reason, unable to continue working after you've returned to work, it is very difficult to get that weekly check re-started.
If the insurance company is asking you to go back to work and you do not feel ready or able to perform the job they are asking of you, the only way the insurance company can stop your weekly check is to go before the Industrial Commission and obtain an order allowing them to stop it.
If the insurance company goes before the Industrial Commission, you or your attorney will have an opportunity to explain why you do not feel able to return to work. After that time, the Industrial Commission will make a ruling. Only if they side with the insurance company, is the check stopped. This process can take several weeks.
It is also important to know that in North Carolina, your doctor must review and approve a written job description before you go back to work. If the insurance company is asking you to go back without a doctor-approved job description for the work they are asking you to perform, they will be unable to stop your check.
Two Clients - Two VERY Different Outcomes
We had two clients recently who dealt with this issue, and they had very different outcomes based on their actions.
One client was contacted by the insurance company and told to return to work. He had been assigned work restrictions and was unable to perform his pre-injury job due to the injury. He felt he had a good relationship with his boss, and thought his employer would work with him. He did not know that the insurance company was required to have a doctor-approved job description. So he went back to work. His employer, however, made him do more than he was physically capable of doing, so he was unable to continue working. Yet because he returned to work, the insurance company was able to cut off his check, and he had to wait for relief until we went before a judge*.
Another client was rightfully hesitant about returning to work when the insurance company asked him to. He heeded our advice, which was to wait until he had a doctor-approved job description. His employer was never able to put together a job description because they did not have light duty work available. He was able to remain out of work and continue to receive his weekly check*. This allowed our client to focus on healing from his injury.
You're not alone. We're proud to say we've helped thousands just like you. Some insurance companies may try to scare you into thinking you don't have a choice or the time to consider your situation before you make a decision. Don't let them back you into a corner.
If you are being asked to return to work and you do not feel ready, give us a call at 1-866-900-7078. Let one of our workers' comp attorneys - five of whom are Board Certified Specialists in Workers' Compensation Law - evaluate your situation for free!
*Each case is unique and must be evaluated on its individual merits. Past results do not guarantee a similar outcome.