If My IME Doctor Alleges I Am Fully Recovered From My Pennsylvania Work-Related Injury, Can They Stop My Checks?

No. If you are receiving Pennsylvania Workers’ Compensation wage loss benefits for an accepted claim, the insurer or third party administrator is not permitted to stop your checks merely because it has received a medical report from a doctor claiming that you are recovered from the work injury. To stop the checks in this situation, the insurer or TPA has to file a Petition to Terminate benefits, request supersedeas, and then have supersedeas granted by the Work Comp Judge.

So, what is supersedeas in a Pennsylvania Workers’ Compensation case? It is a request by the insurer or TPA to the Work Comp Judge to stop the wage loss checks, at the beginning stage of litigation, based on the receipt of medical evidence that there is a recovery. Note, however, that the Work Comp Judge will, before issuing a Decision on supersedeas, allow the injured worker to submit documents that establish the fact that there has not been a full recovery. Injured workers who are not represented by an experienced PA Work Comp Lawyer are at a big disadvantage in this situation and they are urged to seek representation to avoid having their checks stopped. If the lawyer is successful, the Judge will award a 20% fee of the ongoing checks- but the alternative is much, much worse- the checks stopping. The Supersedeas Hearing arrives quickly after a Petition to Terminate (or Suspend) is filed.

Can the Supersedeas Decision be reversed? Supersedeas comes by way of an interlocutory order- which, by definition, means it is not subject to appeal. However, after the Judge reviews all of the evidence at the end of the litigation – including deposition testimony, the final Decision can reinstate the checks. But litigation can take a year or more sometimes-so the supersedeas stage is critical because losing at that level means no work comp checks during the rest of the litigation. This can be a devastating scenario for many injured workers who do not have sufficient savings to carry them through.

One situation where the insurer or TPA can stop the work comp checks without Court Order is when an injured worker returns to work at the pre-injury employer. The insurer or TPA can issue what’s called a Notice of Suspension since the injured worker is back to a regular paycheck. The injurer worker can challenge that Notice if the return to work is not successful. The nature of that specific challenge depends on the length of time the injured worker continued to work.

The Pennsylvania Workers’ Compensation Law has become highly technical and procedural. If you are an injured worker and do not have legal representation with a PA Work Comp Lawyer who only handles PA Work Comp cases, call or email me immediately for a free consult TOLL FREE 1 (877) 560-7090 or mcardamone@krasno.com

You won’t talk with a “runner” or a secretary- you will talk with me directly so that I can give you a complete analysis of your case.

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