Articles Tagged with payment without prejudice

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If you are injured at your job and unable to continue working, your employer’s workers’ compensation insurance carrier can pay you weekly benefit checks and pay for your medical treatment for 180 day — without actually accepting liability for your injury.  This means that, at any point during the 180 days, the insurer can stop paying you weekly checks and medical treatment if they mail you a Form 106, also known as an Insurer’s Notification of Termination or Modification of Weekly Compensation During Payment-Without-Prejudice Period.  This means that the insurer can stop your payments with only seven days notice to you.

The insurer can stop payment for almost any reason.  They can claim that you are capable of doing other work, or that an investigation revealed that you weren’t actually injured at work. However, if your insurer has been paying your benefits for more than 180 days, then they have accepted liability and responsibility for your work injury and cannot stop paying you weekly checks unless they file a Form 108, an Insurer’s Complaint for Modification, Discontinuance, or Recoupment of Compensation.  This requires the insurer to file the claim and go before the judge to request that they be allowed to stop paying your weekly benefits (only a judge can allow this to occur).  The exception to accepting liability if payments are made for more than 180 days is if the insurer sends you a Form 105: Agreement to Extend 180 Day Payment-Without-Prejudice Period .  If you sign this form and return it to your insurer, they can file it with the Department of Industrial Accidents, which allows them to stop paying you your weekly checks with 7 days notice (for up to 360 days).

If your insurer sends you a Form 105, it is important to talk to a lawyer before signing it. It may not be in your best interest, and may result in your weekly checks stopping before you are able to return to work.

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After an Employee is injured on the job, their day to day lives are often thrown into a tailspin. As if being injured and unable to work isn’t stressful enough, most employees are left with the burden of figuring out their finances, attending doctor’s appointments, and being buried in paperwork. Often times, employees rely on and trust their adjusters to help them get through this tough period; unfortunately, adjusters and insurance companies are usually more interested in protecting their own interests. During this difficult time, most employees will receive a Form 105, “Agreement to Extend Payment Without Prejudice Period” in the mail. This form will also be accompanied with a letter that indicates that the employee has been “approved” or “could be paid for up to a year” if they sign the form. This letter is meant to mislead the employee and make them feel as if the form is in the employee’s best interest. It’s not.

Signing the Agreement to Extend 180 Day Payment Without Prejudice Period form can have an extremely negative impact on an employee’s claim. At first glance, the form seems harmless and possibly beneficial to the employee; however, by signing this form, the employee is giving up his or her legal rights — and it may allow the insurer to legally terminate benefits. It may also put the employee in a position where they could go months without benefits while waiting for a court date.

In every case, during the first 180 days from the first date of disability, the insurer is allowed to stop payments to the employee without obtaining approval of the Department of Industrial Accidents or the consent of the employee. The insurer is required to give the employee seven days written notice of the termination benefits.

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