It is very common for an insurance company to modify the amount of a claimant’s weekly workers’ compensation check. Under the New York State Workers’ Compensation Law, the insurance carrier, unless they are under a formal direction made by a Workers’ Compensation Law Judge, must pay in accordance to the medical reports being filed.

The two most common reasons for a reduction in rate are where the attending physician indicated that the claimant’s disability status has gone from a total disability to a partial disability. Total disability means that you are unable to perform any gainful employment. Partial disability means that even if you cannot do your job but you are able to do some type of light duty position, you would receive a partial disability rate. Each time a doctor indicates that you are able to do light duty work, even if that work is not available, you become partially disabled. The insurance carrier receives those reports and then reduces your benefits accordingly.

The second most common reason for a reduction is where the insurance carrier secures a medical report from their consultant. This report is called an Independent Medical Exam (IME) report. It often indicates that ones disability is less than that noted by the attending physician. If there has not been a formal ruling by a Law Judge regarding the proper rate of compensation, the insurance carrier can reduce benefits as soon as they receive their doctor’s report. They have a legal right to disregard entirely your doctor’s opinion regarding disability and pay you in accordance with their medical consultant.

When this happens, prompt action should be taken in order to secure a Workers’ Compensation hearing. At the hearing, the Law Judge will ultimately make the ruling on how much your weekly benefit should be.