If you injure yourself at work and are collecting workers’ compensation benefits, one piece of mail you want to receive less than a letter for jury duty is a Termination Petition filed by your employer’s workers’ comp. insurance company. What does a Termination Petition mean? What should you do in response?
The insurance company is allowed to have you evaluated by a doctor of its choice twice a year. This is called an independent medical examination, or IME. If you undergo an IME, the doctor may be pleasant on the surface and you may walk out of the exam confident that the doctor understands you are still injured and are unable to return to your regular job. Don’t be fooled — these doctors are hired by insurance companies and paid big money to find that injured workers have recovered from their work injuries. So despite the insurance company doctor’s sunny disposition, you may receive in the mail two weeks later a report from the doctor stating that you have fully recovered and are no longer disabled, accompanied by a Termination Petition, in which the insurance company is asking a Workers’ Compensation Judge to cut off your benefits.
About a month after the Petition is filed, a Judge will hold a hearing. A lawyer for the insurance company will submit the report of the doctor who did the IME of you and ask the Judge to grant supersedeas — a legal term meaning the immediate stopping of your benefits. Your lawyer will have time, usually 14 days or 21 days, to submit documents in opposition to supersedeas, which consists of medical records from your treating doctors, and an affidavit by you, stating why you disagree with the IME doctor’s opinion that you have fully recovered. The Judge will almost certainly deny the request for supersedeas and allow you to continue receiving your workers’ comp. benefits while the Termination Petition is litigated (depositions and additional hearings are held). If your lawyer has not been receiving a fee of 20 percent of your benefits from previous litigation, that fee will start if the Judge denies supersedeas.
Over the next several months, evidence will be submitted to the Judge. The insurance company’s lawyer will present the deposition of the IME doctor. Your lawyer will participate in the deposition and have the opportunity to cross-examine that doctor, asking questions to try to discredit his opinions (for example, the doctor’s exam only took 10 minutes, the doctor did not review all of your medical records).
Your lawyer will counter that by taking the deposition of one of your treating doctors. That doctor will describe his exams of you and comment on the diagnostic studies that you have undergone (such as MRIs and EMGs) and medical records of other providers you have seen, such as the hospital emergency room after you first injured yourself and other doctors who have treated you.
At the final hearing before the Judge, typically six to nine months after the first hearing, you will testify and explain why you haven’t recovered from your injuries (for example, you still have pain which requires you to take medication every day) and why you can’t return to your job (for example, you can only lift 10 pounds while your job requires you to lift 50-pound boxes). The insurance company’s lawyer will have the chance to ask you questions and challenge your testimony that you are still disabled from your injuries.
At the conclusion of your testimony, the Judge will give both lawyers time to submit legal briefs in which they summarize the evidence and argue why you have or have not recovered from your injuries. The Judge will then review all of the evidence as well as the briefs and write a decision, either granting or denying the Termination Petition.
There is a chance that a settlement will be reached in your case before the Judge writes a decision. A Judge different from the one hearing your case may hold a mediation (also known as a settlement conference) in which you, your lawyer, the insurance company’s lawyer, and a representative for the insurance company (such as a claims adjuster) participate in an effort to reach a settlement. The goal is to find an amount of money that you are willing to accept and the insurance company is willing to offer.
If a Termination Petition is filed against you, there is a lot at stake because if you lose, you will no longer receive a weekly check and your medical bills will no longer be paid. You need a top workers’ compensation lawyer, one with extensive experience and knowledge, who will represent you vigorously and do everything possible to ensure that your benefits are not terminated — and attempt to negotiate a favorable settlement for you. You need Pearson Koutcher Law — we are recognized experts in the field of workers’ compensation. So if you get the dreaded Termination Petition in the mail — or if you recently injured yourself and want to make sure your rights are protected, call Pearson Koutcher Law for a free consultation.