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Modification of Benefits

For those who have been injured in a work-related accident, Workers’ Compensation benefits are sometimes the only source of income during the recovery period. Any changes to this income, or a termination of benefits, could be catastrophic for a worker who has not yet made a full recovery and has a family to support.

One indication that your employer has an interest in modifying your benefits is a visit from a vocational expert to assess your earning power – in other words, what types of jobs you are capable of doing while you are recovering. There may be a modified or “light duty” job available that the vocational expert feels would be appropriate for your capabilities.

If your employer, or the insurance company, asks you to complete an independent medical exam (IME) by a physician of their choosing, this could be another sign that they intend to modify or terminate your medical or wage loss benefits. If the physician is of the opinion that you are well enough to return to some form of work, then your employer will have grounds to file a modification/suspension petition.

Contact an experienced Workers’ Compensation lawyer immediately if you have concerns about the continuation of your benefits. The Pennsylvania Workers’ Compensation Act gives you the right to receive medical and wage loss benefits if you have been injured on the job. An experience lawyer can help you keep your benefits until you have made a full recovery.

Notification of Changes to Your Benefits

If you are receiving Workers’ Compensation and your employer thinks you can return to work so that they can stop paying your benefits, you will receive a modification/suspension petition in the mail. This is a legal document that asks a Workers’ Compensation Judge to hold a hearing to reexamine the benefits you are currently being paid.

At the hearing, your employer will present evidence as to why you should return to work, either at wages equal to your pre-injury earnings or greater. If they are successful, your wage benefits will be suspended. If you can return to work, but at wages less than what you were previously earning, your wage benefits will be reduced to two-thirds of the difference between your old and new wages.

Next Steps

You will be sent instructions about how to answer the petition. Consider working with an experienced Workers’ Compensation lawyer for assistance in answering the petition within the deadline given and defending your right to benefits at the hearing.

When your case has been assigned to a Workers’ Compensation Judge, you will receive a Notice of Assignment. Then your case will be scheduled for a hearing.

Your employer cannot stop paying your benefits unless the Workers Compensation Judge has issued a judgement about your case.

There are several possible outcomes, including:

  • Your benefits could remain the same if the judge decides you cannot continue working.
  • Your benefits could be reduced to two-thirds the difference of your previous and current wages, if the judge determines you can work again, but at a lesser wage.
  • Your benefits could be terminated if the judge decides you are capable of earning at the same or greater rate as the wages you earned before your work injury.

Appeal

You may appeal the judge’s decision. But during your appeal, you will receive the amount of benefits that were decided as a result of the hearing. For instance, if your wage replacement benefits were lowered, then that is what you will receive during the appeals process. If your wage replacement benefits were suspended, you can only receive medical benefits while you appeal your case.

A successful appeal is rare, which is why is it so important to have a qualified Workers’ Compensation lawyer represent you at the hearing. In certain circumstances, the law gives the Workers’ Compensation Judge the absolute right to make a determination.

Philadelphia Workers’ Compensation Lawyers of Gross & Kenny, LLP Help Injured Workers Retain Their Benefits

At Gross & Kenny, LLP our practice is focused exclusively on helping injured workers and their families. Contact one of our Philadelphia Workers’ Compensation lawyers for answers to all your questions about modification of benefits. Call us at 267-589-0090 or contact us online. We are located in Center City, Philadelphia serving injured workers throughout Pennsylvania