What Is a Suspension of Workers' Compensation Benefits?

Understanding a Suspension of Workers’ Comp Benefits

A Suspension of Workers’ Compensation Benefits is when the Workers’ Compensation Carrier tries to stop your wage loss benefits but not your medical benefits, alleging that you are able to return to work in some capacity — whether regular, medium, light, or sedentary work — according to an Independent Medical Evaluation (IME) report or your own treating doctor’s report.

From the time you begin to receive workers’ compensation wage loss benefits once your claim has been accepted, it is the workers’ compensation adjuster’s job to try and find a way to stop paying you compensation, as it is costing the carrier and your employer premium dollars to have you on workers’ compensation. The workers’ compensation carrier will receive ongoing reports from your treating physicians, and if there is any hint that you can return to your job or the same category of job — such as desk work, light, medium, or heavy duty work — that pays the same as your pre-injury work, the carrier will hire an attorney to file a Suspension Petition to try to stop your workers’ compensation wage loss benefits altogether.

If your treating physicians do not indicate that you are capable of returning to work so that your benefits can potentially be suspended, the workers’ compensation carrier will send you to a physician who they pay to perform a one-time exam. This physician is referred to as an Independent Medical Examiner. It is the hope of the carrier and your employer that the IME doctor will indicate that you are capable of returning to work at the same pre-injury rate that you earned.

If you do not go back to work to try a job that is made available to you within the doctor’s restrictions, the workers’ compensation carrier will ask a Workers’ Compensation Judge to suspend your wage loss benefits. The workers’ compensation carrier will hire an attorney to file a Suspension Petition in support of their position, so be sure to have representation yourself.

If your employer does not have light or sedentary work for you to return to, the workers’ compensation carrier may hire a vocational specialist to interview you and assess your educational background, transferable skills, and work history.

Earning Power Assessment

The vocational specialist will also conduct an Earning Power Assessment to determine what you could be earning based on work found within your restrictions. For example, if the vocational specialist finds that a position such as a “Walmart Greeter” is generally available in your area within your restrictions for $10.00 per hour — equal to or more than what you earned at the time of your injury — the workers’ compensation carrier will petition the court to suspend your wage loss benefits.

This process can get complicated, and the best time to contact a Workers’ Compensation Attorney, if you have not already, is when you are contacted about the IME. Be proactive!