Can the Insurance Company Just Stop My Workers’ Compensation Benefits?

Under the Pennsylvania Workers’ Compensation Act, your employer (or their insurance company) may not stop or change the amount of your benefits unless:

  •  you have signed an agreement allowing  them to do so;
  • they have a Judge’s Order permitting them to do so;
  • you have failed to timely complete requested documents;
  • you have failed to comply with an order requiring you to attend an expert interview

or exam without a reasonable excuse; or,

  • you are incarcerated after a conviction, or you have died.

Agreements which will allow an employer to stop or change your benefits include a Final Receipt, a Supplemental Agreement, or a Stipulation of Facts Agreement. If you and the employer sign such an agreement, your benefits will be terminated or changed. In addition, if a Judge has signed an order  permitting your employer to stop or change your benefits, the employer will do so. A Judge’s Order will only be issued after litigating a Petition or after the employer has made a request, and the Judge grants, a request that you benefits stop while a Petition is being litigated (supercedeas). Your benefits may also be stopped if you fail to comply with an order requiring you to attend an Independent Medical Exam or other expert interview, and you do not have a reasonable cause or excuse for failing to attend the exam or interview. Finally, if you fail to challenge a Notice of Suspension or fail to complete and return forms verifying your income, employment, or physical condition, your benefits may be suspended.

If your employer stops or changes your benefits unilaterally, or for any reason not listed above, a Judge may impose penalties of up to 50% against them for illegally suspending compensation.