When Can Workers’ Compensation Benefits Be Stopped in Virginia?

If you have suffered a work-related injury or illness in Virginia, you may be eligible for workers’ compensation benefits. These benefits can provide wage replacement and medical care while you recover. However, in some cases, your benefits can be stopped even if you have not fully recovered. Read on to understand when this can happen and what your options are. For legal advice tailored to your case, consult with us for free at Slominski Law.

Overview of Workers’ Compensation Benefits in Virginia

The Virginia Workers’ Compensation Act provides several types of benefits for injured employees including:

• Medical care to treat the work injury
• Temporary total disability benefits if the injury results in total loss of wages
• Temporary partial disability benefits if you can work but at reduced capacity
• Permanent partial or permanent total disability benefits if the injury causes permanent impairment
• Death benefits for surviving dependents.

To receive these benefits, you must report your work injury promptly and be under the care of an authorized physician. You also have to cooperate with medical treatment and return to work when possible.

When Can My Worker’s Comp Benefits Be Stopped?

There are a few scenarios where your workers’ compensation wage benefits can be suspended or terminated in Virginia:

Reaching Maximum Medical Improvement

Maximum medical improvement (MMI) is one of the most common reasons temporary disability benefits end. MMI means that your work injury has healed as much as it is going to with medical treatment. Your doctor does not expect any major changes in your impairment going forward. There may still be some ongoing symptoms or disability, but substantial recovery has occurred.

Reaching MMI often happens many months or even years after a serious work injury. It takes time for damaged tissues and bones to heal. Your doctor will determine when you’ve reached MMI based on:

• Your response to medical care so far
• Test results showing healing progress
• Whether your functionality has plateaued.

Once your doctor declares MMI, you likely will not need extensive medical care anymore. Temporary disability benefits – which are intended to replace wages while you recover – will be discontinued. However, you still have a right to medical treatment for flare-ups and maintenance care after MMI. And if you have permanent impairment, you may qualify for permanent disability benefits.

While MMI usually signals the end of temporary wage replacement, your medical rights continue for life in Virginia workers’ compensation cases.

Non-cooperation with Medical Care

Another reason temporary disability benefits sometimes terminate prematurely is an injured worker’s alleged failure to cooperate with medical treatment. As a Virginia workers’ compensation claimant, you must follow prescribed medical care to continue receiving wage replacement and other benefits. That includes things like:

• Showing up to appointments with authorized treating physicians
• Following doctor’s orders like taking medication or doing physical therapy
• Undergoing testing or procedures deemed necessary by your providers.

If you are non-compliant with medical care without a valid excuse, your benefits can be suspended. Examples of non-cooperation include:

• Repeatedly missing medical appointments
• Refusing to participate in physical therapy
• Declining to get medically recommended surgery.

Before cutting off benefits, the insurer or employer has to send you written notice explaining:

• How you failed to cooperate with your doctor’s medical plan
• The date benefits will be suspended if conduct does not change
• Your right to challenge the allegations.

Sometimes, insurers falsely accuse injured workers of being non-compliant with medical care as an excuse to stop benefits. That is why injured employees must stand up for their rights if they believe benefits were wrongly terminated. With legal representation, you may be able to get benefits reinstated by providing evidence such as:

• Medical records showing participation in treatment
• Documentation of appointment attendance
• Justification for any lack of cooperation due to circumstances beyond your control.

Don’t let false allegations rob you of the wage replacement and medical care you deserve. Fight back against wrongful termination of benefits with the help of an experienced work comp lawyer.

Being Released to Return to Work

Another reason temporary disability benefits often terminate is being released to go back to work by your doctor. As your work injury heals, you hopefully will regain functionality, experience less pain, and have fewer limitations over time. Eventually, your treating physician may determine you can return to your pre-injury job or alternate employment.

Once your doctor says you are physically able to work again, the law expects you to return to employment if possible. At that point:

• If you’re released to full duty, temporary total disability payments will be stopped since you can resume making full wages again.
• If you’re released to light duty, temporary partial disability benefits may be reduced or suspended depending on your earnings.

Keep in mind that just because your doctor releases you does not necessarily mean you are totally recovered. You may still have permanent impairment or disabilities that affect your capacity to work. Make sure to communicate openly with your doctor about your ongoing symptoms and limitations before being released. That way, any permanent work restrictions can be accounted for.

If you believe you are still entitled to temporary disability benefits after being released prematurely, speak to an attorney. In some cases, benefits are wrongly terminated when an injured worker is not truly able to return to employment.

Refusing Suitable Employment

When you get a release to come back either full duty or light duty, you must make reasonable and good faith efforts to return to employment. If your doctor says you are able to work but you turn down an appropriate job offer within your restrictions, your benefits are at risk. However, the work offer has to legitimately fall within your limitations and qualifications to be considered suitable employment. Factors include:

• The job’s physical demands and your medical release
• Your skills, background, and pre-injury earnings
• Availability of the job close to your residence
• Safety of the work environment.

You should not be expected to take work that pays substantially less than your pre-injury wages or work in which you have no experience.

If you try returning to a job but cannot physically perform the duties, your benefits should not be terminated. Show that you’re making reasonable efforts to work again in accordance with your doctor’s release.

If your benefits are discontinued after alleged refusal of employment, be sure to seek legal assistance right away. An attorney can help show evidence that:

• The job was not within your restrictions so refusing was reasonable.
• You did make efforts to return to work but physically could not handle duties.
• Lost wages are attributable solely to your work injuries.

With a strong case, your attorney can fight to prove wrongful termination of benefits and get your income replacement restarted.

Settlement or Final Award

You have the option to settle your case instead of receiving weekly comp payments. Settlement typically involves the insurer paying you a lump sum of money to close out your claim. In return for the payout, you give up rights to any further temporary disability or medical benefits.

If your case does not settle, it may go through litigation and ultimately result in a permanent partial or total disability award ordered by the Commission. Such a final award grants you permanent disability benefits but also cuts off additional temporary wage replacement. (Note, however, that while temporary wage replacement stops after an award, your right to medical treatment for the work injury continues for life in Virginia.)

So in either scenario – settlement or final award – temporary income benefits end because your claim has come to a conclusion. At that point, you collect the monetary compensation owed to you and move on.

Permanent Disability Awards

Another milestone that generally stops temporary disability benefits is receipt of a permanent disability award. A permanent partial or permanent total disability award is granted once your work injury claim is fully adjudicated by the Virginia Workers’ Compensation Commission. The award specifies compensation you will receive for the lifelong loss of function and earnings capacity caused by your work accident.

These permanent disability benefits awarded by the Commission are paid weekly or monthly and provide income well into the future. They take the place of the temporary wage benefits you collected earlier while recovering.

Sometimes it takes years for a disputed claim to result in a final award, with many ups and downs along the way. But once the Commission orders permanent benefits, further temporary income replacement is cut off. At that point, the focus shifts from temporary recovery to handling permanent disability and impairment through the award payments and lifelong medical rights.

Return to Work and Termination of Benefits

As discussed above, being released to return to work often results in termination of temporary disability payments. However, the end of wage benefits is not automatic anytime an injured worker goes back on the job. Whether your benefits stop under Virginia workers’ compensation law depends on:

• The circumstances of your return to work
• The amount of wages you are earning
• The cause of any lost wages.

To sort out how return to work affects your specific situation, consider the following:

Returning to Full Duty

If your treating physician releases you to return to full duty – meaning you can perform all the tasks of your pre-injury job without restriction – your temporary total disability payments will likely stop. The reasoning is that you supposedly can resume making your full wages again, so you would not qualify for income replacement benefits anymore.

However, if you return to full duty work but end up earning less money due to your injury, you may be able to get your temporary partial disability benefits restarted. You would need to show that lost wages are directly attributable to physical limitations from the work accident. An experienced attorney can help you make this case to get benefits flowing again if unfairly terminated.

Returning to Light or Modified Duty

Often, injured employees are released to return to work but on light or restricted duty. This means performing less physically demanding tasks within medical limitations. Going back to light duty usually results in reduction or suspension of temporary partial wage benefits under Virginia law.

The extent that benefits are decreased depends on how much you are earning compared to your pre-injury average weekly wage. Your benefits may go down substantially if you are making close to your full wages on light duty. Or they could be just minimally reduced if the alternate work pays much less.

In the best-case scenario, you earn equivalent wages on light duty, which means temporary benefits are suspended entirely. If your earnings then dip again directly due to your injury, your attorney can fight to get those benefits reinstated.

Losing Your Job After Return to Work

Sometimes, an injured employee goes back to work but is later terminated or has to quit because they simply cannot physically handle the duties. In this situation, you need to be able to show that lost wages are specifically attributable to your work accident injuries to restart temporary disability benefits.

For example, if you are fired for misconduct unrelated to your injury, you likely cannot get your wage benefits turned back on. In that case, you lost wages because of your own actions rather than your disability. Likewise, if you voluntarily resign your employment for reasons unrelated to your work accident, benefits may be denied.

To sum up, anytime your circumstances change after your return to work, speak to an attorney about how it impacts your wage benefits claim. You want to make sure you are receiving all the temporary income replacement the law entitles you to.

My Worker’s Comp Benefits Were Cut Off. What Are My Options?

If your benefits were prematurely terminated, speak to an experienced Virginia workers’ compensation attorney right away. Attorney Jaleh Slominski at Slominski Law can review your case and help you understand your rights. You may be able to challenge the termination of benefits by:

• Providing medical evidence that you are still temporarily disabled
• Demonstrating cooperation with medical treatment
• Appealing a denial of benefits with the Workers’ Compensation Commission
• Negotiating reinstatement of benefits.

With legal help, you may restore the benefits wrongly taken away from you. Don’t wait to act if your wage or medical benefits were unfairly discontinued.

Appealing Wrongful Termination of Benefits

If your workers’ compensation wage or medical benefits were discontinued without good reason, you have legal options to fight back. In Virginia, the Workers’ Compensation Commission provides an appeals process for injured workers whose benefits were prematurely terminated. You can request a hearing before the Commission to present evidence showing:

• You remain temporarily disabled and entitled to income benefits.
• You did cooperate fully with medical treatment.
• Alleged suitable employment was outside your restrictions.
• Lost wages are solely attributable to your work accident.

With documentation and testimony supporting your claim, the Commission may order reinstatement of your benefits. They also have authority to award back payment of any benefits wrongfully withheld while terminated. It is important to appeal as soon as possible when your benefits are improperly suspended or denied. This helps limit gaps in wage replacement and medical care so you can focus on recovery.

Why You Should Consult a Workers’ Compensation Attorney If You Are At Risk Of Losing Your Worker’s Comp

Because the termination of benefits can severely impact your income and medical rights, you should always consult an attorney when you receive this notice. An experienced lawyer can assess whether the discontinuation was justified under Virginia law or if grounds exist for an appeal. 

A good attorney should aggressively defend your rights to ensure you receive all the workers’ compensation benefits you deserve. Do not delay in reaching out for legal help if you face cut off of wage or medical benefits.

Frequently Asked Questions About Workers’ Compensation Getting Cut Off

Can my benefits be terminated while I’m still recovering and unable to work?

No, temporary disability benefits cannot be stopped as long as you remain unable to work at full capacity. However, the insurance company may dispute whether you are still temporarily disabled. Hiring an attorney can help protect your ongoing right to benefits.

My doctor released me to light duty. Can I lose my benefits for refusing to take a different job?

Potentially, yes. If the workers’ comp insurance carrier offers you a suitable job within your restrictions that pays comparable wages, your benefits may be at risk if you decline the position. However, the job must truly match your abilities and limitations.

Does being fired from my job end my workers’ compensation benefits?

No, being terminated from employment does not impact your legal rights to wage loss replacement or medical benefits under a workers’ comp claim. An injury claim is separate from employment status. However, finding new work may be required at some point.

Compensation Benefits Can Be Stopped. Contact Slominski Law For Help Today.

While you may expect workers’ compensation benefits to automatically continue while you are injured, there are scenarios in Virginia when they can be halted. Common reasons include reaching maximum medical improvement, getting released to return to work, settling your claim, or a final disability award. However, in some cases benefits are wrongly discontinued based on false allegations or misunderstandings of the law.

That is why you need to consult with a lawyer specializing in Virginia workers’ compensation any time your benefits are threatened with termination. For knowledgeable legal help, the experienced attorneys at Slominski Law offer free consultations on denied or discontinued workers’ compensation claims in Virginia. Call us at (434) 384-9400 (Lynchburg) or (540) 554-3762 (Roanoke) to discuss your case.