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When can the Insurance Company Stop my Wage Benefits?


Georgia’s workers’ compensation law does not allow insurance companies to stop paying you your weekly wage benefits unless they follow certain procedures.  If they do cut you off without following the law, we can ask the State Board to impose penalties and sanctions against them.

Once benefits have been started, the insurance company will have to file a designated form and serve you a copy to give you notice if they intend to cut you off.  Thus, if you receive a copy of a form from the insurance company that seems to say that your benefits are being terminated, you should contact your lawyer immediately.

Here is an overview of when the insurance company can terminate benefits:

  • the insurance company can cut you off once they have paid you 400 weeks of temporary total disability (weekly wage) benefits.  400 weeks equals to about 7 1/2 years.
    • the 400 week cap does not apply to “catastrophic injuries”
  • the insurance company can cut you off if your authorized treating physician returns you to work with no restrictions
  • the insurance company can cut you off if you return to work and you earn the same as what you were earning when you were hurt
    • if you return to work and are earning less than you did when you were hurt, you are eligible for TPD (temporary partial disability) benefits that are calculated based on the difference between your pre-injury pay and your return to work pay.
  • the insurance company can cut you off if the employer offers you a light duty job and you refuse to try it
  • the insurance company can cut you off if they present an argument to the State Board and win.
    • for example, if the insurance company hires a private detective to follow you and the detective videotapes you lifting weight at the gym or working on your roof, the insurance company can request a hearing to terminate benefits

Because Georgia workers’ compensation is very procedure oriented and form driven, there should be no surprises in terms of your weekly wage benefits.  Again, if you get a State Board form in the mail, call our office.

 

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