- it is ordered by an arbitrator, administrative judge, reviewing board, or higher court;
- you have returned to work (the insurer must resume benefits if within 28 days you leave work again due to the same injury, provided that the insurer has accepted, or been assigned, liability for your injury);
- the insurer has been given a medical report by your treating doctor or an impartial medical examiner stating that you are capable of returning to work, and your employer has reported in writing that a suitable position is available for you that your doctor has approved;
- you are requested to attend an evaluation by a DIA vocational rehabilitation review officer and you refuse to attend, or refuse to cooperate with the provision of vocational rehabilitation services;
- you are asked to go to the insurer's doctor for evaluation, and you fail to attend;
- you are imprisoned after conviction for either a misdemeanor or felony.
Lump sum settlements
A lump sum is a settlement or contract between you, the insurer, and in some cases your employer. This one-time payment may be made in place of your weekly compensation checks and certain other benefits. In accepting a settlement you give up certain rights, so you must carefully consider whether or not settling your case is in your own best interest.
If the insurer has accepted legal liability for your injury, when you lump sum your case your medical benefits will remain open. This means the insurer must continue to pay for necessary and reasonable medical treatment and vocational rehabilitation services. The insurer still has the right, however, to deny any treatment it feels is unnecessary or unreasonable. For a lump sum brochure further explaining your rights, please go to our website or call our Public Information Office to have one sent to you.
Do you need an attorney?
You do not need an attorney to file a claim for benefits, and you are not required to have an attorney for any proceedings before the department. You may represent yourself, or be represented by anyone you delegate, including an attorney. If you do get an attorney, the law requires that the insurer pay their fee if you win your case. In certain cases the insurer can reduce payments to you to help pay for your legal representation. If you lose, the attorney can charge you only for very specific expenses.
Vocational rehabilitation services
If a doctor decides that due to your injury you will not be able to return to your job you may be eligible for vocational rehabilitation services. The goal of vocational rehabilitation is to get you back to work earning as close as possible to what you were making prior to your injury. Vocational rehabilitation services cover all non-medical services that you may require to return to a suitable job.
Services may include evaluation of your capabilities; vocational testing; counseling or guidance; workplace modifications; and/or, job placement assistance/formal retraining.
If you are requested to meet with one of our vocational rehabilitation review officers you must attend this meeting. This meeting is to determine if you are a suitable candidate for these services. If you refuse to come to this meeting your benefits can be discontinued. If you refuse to take part in a rehabilitation program after being determined suitable, your weekly benefits can be reduced by the insurance company, with the permission of this department.