You are receiving workers’ compensation benefits and your injury has been accepted by the employer and workers’ compensation insurance carrier. Regular weekly or bi-weekly wage replacement checks are being sent and your medical bills for the treatment of your work injury are being paid. What can go wrong now?  

    Remember, you receive two benefits: wages and/or medical benefits.  

Your wage replacement checks may stop arriving at regular intervals or you may begin to receive your checks late. They may arrive a day or two or perhaps a week late. You also may begin to miss an occasional check or your checks may stop altogether.

    These problems are usually clerical or technical errors. Usually a phone call to your adjuster will solve the problem. 

We recommend that you monitor your checks carefully. Each check should indicate the period of time for which the wages are paid. For instance, a check may state “TTD 1/1/10 – 1/7/10” or “1/1/10 – 1/14/10”. This means that you are receiving temporary total disability benefits (wages) for a seven or fourteen day period of time. Your next check should indicate a period beginning with the very next day. In the examples above, the next check would be for the period 1/8/10 – 1/14/10 or for a bi-weekly check the period 1/15/10 – 1/29/10.

    The bottom line is monitor the dates of your checks carefully. 

Payment of your medical treatment should be made within 30 days of the insurance carrier’s receipt of your doctor’s bill and medical report form. The insurance carrier has the right to pay the bill within 30 days, deny the bill as being unrelated to the work injury or challenge the reasonableness or necessity of the bill by filing a Utilization Review.

If the Utilization Review is unfavorable to you, the medical bills will not be paid. This unfavorable decision can be appealed to a Workers’ Compensation Judge.

If the Utilization Review is favorable to you, then the bills will be paid, but the insurance carrier can file an appeal to a Workers’ Compensation Judge.

While you are receiving workers’ compensation benefits, you should be aware of different possible future events which are more thoroughly covered in other parts of this website.

Evaluations: The insurance carrier has the right to schedule you for periodic evaluations. These evaluations include an independent medical exam (IME), an impairment rating evaluation (IRE) and a vocational evaluation. 

Job Offer: If you are released to return to work with restrictions, you may receive an offer to return to work. Usually, after a physician releases you to return to work for restricted duty or full duty, the insurance carrier will send you a Notice of Ability to Return to Work. 

Petitions: The most common petitions are Suspension, Modification and Termination.

Surveillance: You may be under surveillance at your home, on the street or even at your doctor’s office.