Last Updated: 5/18/2023
There are many different times when the workers' compensation insurance company will stop paying benefits. First of all, there are two types of benefits which are temporary and permanent.
Temporary benefits (TTD- temporary total disability or TPD- temporary partial disability) may be stopped when:
· The injured worker returns back to work;
· The employer offers work to the injured worker which the injured worker refuses;
· The injured worker is placed at MMI (maximum medical improvement);
· The insurance company sends an Auxier notice stating that they will be terminating the weekly benefits in 30 days;
· The insurance company denies the workers' compensation claim based upon your medical records of their "independent" medical examiner report even if the doctor never examined you; and/or
· The insurance adjuster is on vacation and forgot to put it into the computer system to pay you while he or she is gone. No, this is not a good excuse and could subject the insurance company to be required to pay a penalty of up to 50%. Keep in mind that they will not pay you the penalty owed voluntarily and you will need legal help with that.
When it comes to permanent benefits, there are several things to consider. Generally, the insurance company will only pay permanent benefits (PPD- permanent partial disability) if there has been a permanent functional impairment rating issued by the doctor they have sent you to or you have had surgery and they are voluntarily paying PPD while they are waiting on the impairment rating. (Note: often the insurance company will send you a letter explaining what permanent benefits they plan to pay. Often what the insurance company is going to pay you, is only a small part of what you are owed and we do not take any fee on what they voluntarily pay you).
After the impairment rating has been obtained, here are some reasons that PPD benefits may stop:
· The insurance company has paid the entire functional impairment rating;
· The insurance adjuster is on vacation or their computer system for some "unknown" reason stopped sending out your checks;
· The insurance company has decided to deny your claim based upon an IME ("independent medical examination"); and/or
· You obtained an arbitration decision and all the benefits have been paid under it.
If you or someone you care about has been hurt at work and has an Iowa claim, then you may be confused or worried about what to do next. Because of this, we offer injured workers at no cost our book, the "Iowa Workers' Compensation- An Insider's Guide to Work Injuries". In our book, you will learn how to avoid 7 Common Costly Mistakes, the Iowa Injured Workers Bill of Rights and much more. If you have immediate questions feel free to call us at (641) 792-3595. There is no cost or obligation.