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I slipped and fell at a warehouse, MRI shows 2 tears in rotator cuff. My primary doctor will not let me go back work. I seen another doctor for the insurance company doctor he reports I can work without any limits. I move furniture for a living. My insurance went with the independent doctor. Also saw a surgeon he recommends surgery before I can go back to work. They paid for about ten months then stopped paying. On my benefits they will pay for 2yrs unless they believe I can work. Doctor will not let me go back to work, have no money coming in. I am an independent contactor trying not to sue and loose my job. PLEASE ANY ADVICE THANKS STEVE
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Hi Steve,
The workers' compensation insurer will always work hard to terminate your workers' compensation benefits. That almost always includes sending you to a doctor employed by the insurance company to examine you and evaluate your injuries.
You have up to 3 years of benefits paying you 60% of your average weekly wage (temporary, totally disabled benefits under s.34 of MGL c.152) and up to 4 years of benefits paying you 45% of your average weekly wage (partial disability under s.35 of MGL c.152). During that time period, the insurer may terminate your benefits, as in your case. During a certain time period (the pay without prejudice period), they may terminate your benefits without a judge's approval, if they have supporting evidence of a work capacity. After the pay without prejudice period, they may only terminate your benefits with a judge's approval. This is typically after a conference or a hearing where evidence is presented by the insurer and the employee. It is good that you have a physician opining that you are currently disabled, but the insurer probably has an opinion stating the opposite. The next step would be to file a claim with the Massachusetts Department of Industrial Accidents and work to get you back on workers' compensation benefits.
The law is very complicated, and I only touched upon the many issues involved in a workers' compensation case. A competent attorney is needed to evaluate your claim and further discuss your options. Please call my office.
John Pomykato
(617) 423-0001
pomykatolaw.com
Answered on Sep 23rd, 2013 at 3:28 PM