When an employee gets hurt on the job, the workers’ compensation coverage that you carry will help protect you from liability. It will also help protect that worker from financial hardship caused by their work-related medical issue.
Whether you carry a policy or have self-insured your company, a worker may receive both health care benefits to cover their necessary treatment and indemnity or disability benefits to replace their lost wages.
The cost of those benefits can become quite expensive in some cases. When do you have the option of ending a worker’s coverage?
When they have achieved maximum medical improvement
One of the most common reasons to end someone’s workers’ compensation coverage is that they have already improved as much as is likely given their diagnosis. When someone achieves maximum medical improvement, their eligibility for ongoing treatment may end.
If a doctor reports that the worker is unlikely to regain more function or reduce any lasting symptoms, then it may be about time to consider tapering them off of benefits and getting them back to work.
When they don’t comply with medical instructions
Workers need to follow through with performing physical therapy exercises or taking medication so that they can fully recover from an injury. Failing to take the right steps may undermine the success of the treatment that your company finances or just be a means to continue receiving disability pay for longer.
If you have proof that someone has been medically non-compliant, that may give you reason to terminate their ongoing benefits.
When they can return to work
Sometimes, a worker isn’t fully recovered but has improved their function enough through treatment or rest that they can start doing some work for your company again.
Having them come back on light duty job responsibilities or even allowing them to take over an administrative role while they work from home can be a way to end disability or indemnity benefits for a worker who still requires some medical coverage.
Frequent communication with the employee, an honest evaluation of their job responsibilities and a review of the claim so far can help you determine when it is time to terminate ongoing benefits. Understanding your obligations as an employer can help you handle complex workers’ compensation claims appropriately.