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When is it appropriate to terminate workers’ compensation benefits?

Imagine having a worker come to you to tell you that they were hurt on the job. The way they say they got hurt doesn’t make much sense to you, but you agree to help them with their workers’ compensation claim since you can’t prove that they didn’t get hurt on the job.

Then, you find out from another employee that the worker actually hurt themselves on purpose. That’s a shock, of course, but after reviewing the evidence they brought to you, you believed that it was most appropriate to terminate the workers’ compensation benefits.

Terminating a worker’s benefits isn’t always straightforward

As a business owner, it’s good that you’re trying to be fair in this situation. After all, injuries are not always straightforward, and accidents that seem unusual might really be a result of a number of unexpected conditions.

However, if you believe that the worker is attempting to commit fraud, then it is your right to look into terminating their benefits. If you do take action to do this, keep in mind that your employee may appeal the decision, and you will need to defend yourself.

When are some times when it may be appropriate to terminate workers’ compensation?

It may be reasonable to terminate workers’ compensation if the worker:

  • May be committing fraud to obtain benefits
  • Refuses to go to an independent medical examination
  • Fails to come back to work on return to work dates
  • Fails to cooperate with an investigation

These and other situations are possible times when it would be appropriate to terminate workers’ compensation. The suspension of a worker’s benefits may be allowed based on other circumstances, as well.

This is a time when it’s smart to have the law on your side. You will need to investigate and to be able to prove that the worker did something that should result in the termination of benefits. Since the worker is most likely to appeal any decision you make, it is worth taking the time to be sure you are in the right before you terminate workers’ compensation benefits. That way, you will have a stronger case for what happens next.