Your workers’ comp checks can stop suddenly. Knowing why this happens helps you protect your income.
The 180-day payment window
Massachusetts lets insurers pay benefits “without prejudice” for up to 180 days. This means the insurer can stop payments during that period without asking a judge first.
Once payments extend past 180 days, the rules shift. The insurer must file a formal complaint with the Department of Industrial Accidents and prove its case before a judge can reduce or end your benefits. Massachusetts General Laws Chapter 152, Section 34 sets the legal framework for these timelines and caps.
Common reasons insurers cut off benefits
Insurers cut off benefits for a few common reasons. Here is what to watch for:
Medical release: Your treating physician clears you to return to work, and the insurer adjusts your wage benefits.
Independent medical exam: The insurer’s chosen doctor disputes your restrictions or attributes your symptoms to a pre-existing condition.
Earning capacity: The insurer claims suitable light-duty work exists in your area, even if no actual job offer has been made.
Failure to cooperate: Missing an IME or skipping vocational rehabilitation can be used as grounds to stop payments.
Fraud: Misrepresenting your injury or working while collecting benefits can end your claim and may lead to criminal charges.
Keeping detailed medical records is the best way to protect yourself against these arguments.
How long benefits can last
How long you collect depends on your injury. Temporary total disability pays up to 156 weeks if you cannot work at all. Temporary partial disability pays up to 260 weeks if you can work in a limited way. Both types cap at 364 weeks combined. If your injury permanently stops you from working, you may qualify for lifetime benefits. Medical coverage has no set end date as long as your treatment is necessary and related to your injury.
What to do if your benefits are at risk
A termination notice is an insurer’s position, not a final decision. Many workers have benefits reinstated after a DIA conference or hearing. Speaking with a workers’ compensation attorney may clarify how these rules apply to your situation. An attorney can help you understand your options and respond before key deadlines pass.
