Benefits taken away for knee injury while working on a roof?

by Scott

I tore my medial meniscus in my left knee while working. Surgery was performed and I went through some rehab. While my knee wasn't back to 100%, I was released back to work (injury in July, surgery in August, released to work in November). In early December I told my employer I still wasn't sure if I felt good enough to return.

I called my workers' compensation rep and told him this, and said I was making an appointment to see my doctor again. He said okay and that was that. The doctor ordered an MRI to possibly see what the problem was and removed me from work, although he never gave me a paper to give to my employer stating this, I told my boss personally.

I called the WC rep and told him that the doctor ordered an MRI and said not to return to work, once again he said okay. From Dec 17 through April 8th I had 3 doctor visits, 1 MRI and did 4 weeks of physical therapy.

Just last week in a conversation with my WC rep he was suddenly shocked to find out that I had not been working since Dec 17th, although I verbally told him this and he had access to all information from my doctor since Dec 17th.

Now I'm being ordered to have an IME and they have stopped benefits until they can determine if my continued pain is from my work related injury. Can they do this? What can I do to make sure they don't take away my benefits? Any information or suggestions would be great. Thank you.

Visitor Question:
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ANSWER for "Benefits taken away for knee injury while working on a roof?":

Scott (California):

Your benefits can be halted when the primary care physician decides you have reached a maximum medical improvement (MMI), or are otherwise fit to return to work duties, if those duties are modified.

The workers' compensation insurance company has a right to have you submit to an independent medical examination (IME). If that examination concludes you are able to return to work at full, or modified duties you may have to return to work.

However, if you don't agree with the findings of the IME, you can ask for an additional IME by a physician of your choosing. Hopefully, that physician will conclude you are unable to return to work. If so, workers' comp should cover you while you are unable to work.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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