Employees who are injured on the job in North Carolina may be entitled to workers’ compensation benefits until they are released from medical treatment and return to work. However, some employers and their insurance administrators may attempt to stop workers’ compensation checks before an injured worker can resume work. If an employer’s insurance company does this arbitrarily, you need an experienced workers’ comp lawyer to stand up for your rights to full benefits.
At Younce, Vtipil, Baznik & Banks, P.A., our attorneys understand that injured workers depend on workers’ compensation benefits to pay their bills until they have reached maximum medical improvement and can return to work. Understandably, they are concerned about any interruption of those benefits. Clients frequently ask us, “Can workers’ comp stop paying without notice?”
A workers’ compensation insurance company can’t legally stop paying workers’ compensation payments without notice. If an insurer issues a workers’ comp payments stop, you have the legal right to file an objection and fight for your continued benefits. An experienced workers’ compensation attorney can help you understand how North Carolina workers’ comp laws apply to your work-related injury case and discuss what legal options are available to you.
When Can Workers’ Comp Stop Paying Benefits?
An employer or their workers’ compensation insurance company is required to file a Form 24 to terminate or suspend payment of benefits (N.C.G.S. § 97-18.1). The reasons for seeking to stop benefits include the following:
- Full-Duty Release: If your authorized treating physician determines that you’re able to return to work without restrictions, the insurance company may ask the North Carolina Industrial Commission (NCIC) for permission to stop your benefits.
- Refusing a Job That Fits Your Restrictions: If your doctor says you can work in a light-duty capacity, you must try to return to work. The insurance company can stop your benefits if you refuse to take the job without a good reason.
- You’re Not Following Medical Instructions: If you skip medical appointments or refuse to participate in vocational rehabilitation, an insurer may cite these actions as grounds to stop your benefits.
- You’re Not Following Workers’ Comp Rules: Receiving your benefits is contingent on following certain rules. For instance, you must return all required paperwork as required, and you can’t work and earn money without reporting it. If you don’t comply with the rules, you risk losing your benefits.
Can the Insurance Company Stop Paying Workers’ Compensation Without Notice?
No, insurance companies are not legally allowed to stop paying workers’ comp benefits without notifying both you and the North Carolina Industrial Commission. To stop paying your benefits, the insurer must file a Form 24, explain why they believe your benefits should be terminated, and then await a decision.
Under North Carolina law, compensation must be paid “periodically, promptly, and directly” to the injured employee. The first installment is due within 14 days of having your benefits approved, and subsequent wage replacement benefits are typically paid weekly (N.C.G.S. § 97-18). If you stop receiving your benefits without notice, you may have questions about what to do. You should contact a law firm that handles workers’ compensation cases and request a case evaluation.
Can the Insurance Company Be Penalized for Cutting Benefits Without Notice?
Yes, insurers may face serious consequences if they discontinue your benefits without providing proper notification. Some of the consequences might include:
- An Order to Resume Payments Immediately: The North Carolina Industrial Commission may order the insurer to reinstate your benefits immediately and pay all missed checks.
- A 10% Late Payment Penalty: If the insurer stops or delays payment without a valid reason, they may have to pay a 10% penalty on any compensation you’re currently owed (C.G.S. § 97-18).
- Sanctions or Attorney’s Fees: In some instances, the insurer may have to pay the attorney’s fees the injured worker incurred while trying to reclaim their rightful benefits.
- Reputation Impact: Stopping payments without notification can damage an insurer’s credibility. They may face complaints from the North Carolina Department of Insurance.
What Can You Do When Workers’ Comp Stops Paying?
If your benefits stop without notice, you may ask, “Can you sue workers’ comp for stopping payment without notice?” You should take the following steps:
Contact a Workers’ Compensation Lawyer
Time is of the essence. Contact a workers’ comp attorney as soon as possible for a free consultation. Understanding your options is the first step in the process of seeking reinstatement of your benefits.
Act Immediately
You typically only have 17 days from the date on the notice to respond and request a hearing before the North Carolina Industrial Commission. Missing the deadline can result in the forfeiture of your right to appeal. An attorney can file Section B of Form 24 and return it to the NCIC and insurer in a timely fashion.
Request an Informal Hearing
Once you file a request for an informal hearing, the Industrial Commission will schedule a telephone hearing within 25 days.
Seek a Second Opinion
If your physician issued a full duty release, but you continue to have limitations, you must present evidence to prove this by seeking a second medical examination.
File a Motion for Penalties
You may be entitled to a 10% penalty if payments were late or stopped without notice. Your attorney can file a motion with the Executive Secretary’s Office and include documentation that you missed checks and are entitled to penalties.
Get Legal Help from Our Workers’ Compensation Lawyers
Having your benefits stopped without notification can be stressful. However, with the help of an experienced workers’ compensation attorney, you can build a strong case for having your benefits reinstated and seeking penalty payments from the insurance company.
The team at Younce, Vtipil, Baznik & Banks, P.A., has over 90 years of combined legal experience standing up for North Carolina workers’ rights. Although each case is unique and past results cannot guarantee future outcomes, our reputation is backed by a strong history of substantial settlements and a long list of testimonials from satisfied clients, such as the following:
“Mr. Baznik handled my workers’ compensation case and stayed well ahead of it. Always keeping me informed and going the extra mile for my needs. I’m so glad I chose to call Joe Baznik and will use his team again if I ever need an attorney.” – Jon Connell, former client
If you are saying to yourself, “Workers’ comp stopped paying me without notice,” you don’t have to fight for benefits on your own. Our dedicated attorneys can lead you through the claims process and demand all the workplace injury benefits available to you under North Carolina law. Our law firm represents injured workers on a contingency fee basis. You will not owe an attorney’s fee unless we obtain compensation for you. Contact us today for your free case evaluation.
About the Author
Robert C. Younce, JR
Robert C. Younce is an attorney at Younce, Vtipil, Baznik & Banks, P.A. and concentrates his law practice on personal injury and workers’ compensation law. He has tried over 100 workers’ comp cases to Opinion and Award and about a dozen personal injury jury trials to verdict. He has been board-certified by the North Carolina State Bar as a specialist in workers’ compensation law since 2001.
