Could You Be Required To Repay Your Workers' Compensation Benefits?

Law Articles

If you've recently suffered an on-the-job injury and are currently recuperating at home, you may be receiving workers' compensation benefits through your employer's insurer to help compensate you for medical expenses, lost wages, and other costs you've incurred following your injury. While these benefits are paid out pursuant to an insurance policy and are generally yours to keep (or spend), there are a few situations in which you may find yourself receiving a letter requesting repayment of these benefits months or even years after receiving them. What are your options if you're required to repay these benefits? Read on to learn more about the situations in which you could be legally required to repay some workers' comp funds. 

When can you be required to repay workers' comp benefits?

Workers' compensation is administered on a state-by-state basis, which means that some states may have more stringent repayment requirements than others. However, each state will usually require you to repay at least a portion of workers' compensation funds received in one of three situations: 

  • You recover funds in a personal injury lawsuit

Double-dipping benefits generally isn't permitted when receiving workers' comp. This means that if you collect medical payments and lost wages from your employer's insurer and then file a personal injury lawsuit against your employer or another entity, you may be required to repay benefits received if you later collect a judgment on the same grounds. However, you won't be required to repay benefits above and beyond the amount you've received -- so the worst that can happen in this situation is that you'll be required to turn over the entire judgment (minus attorney fees) to the workers' comp insurer through a judgment lien. If you've received punitive damages above and beyond your actual expenses, these funds shouldn't be subject to repayment demand, but you may be required to pay attorney fees from the remaining portion of your judgment.

  • You are charged with fraud while receiving the benefits

Continuing to collect workers' compensation benefits for lost wages while claiming you're unable to work due to your (short-term or permanent) disability means that you can't do physical activities that rival the level of activity required to perform your regular job. If an investigator catches photos of you mowing the lawn or cleaning out the gutters while complaining that your back pain prevents you from returning to work, you may find yourself facing a repayment demand or even criminal charges of fraud.

You also can't earn an income while receiving workers' comp benefits -- in many cases, even doing freelance work that doesn't involve physical activity may be enough to trigger a repayment request.

  • You received an overpayment or a rerouted payment meant for another entity

If you received (and cashed) a check meant for someone else, or received funds designed to compensate you for medical expenses that were later reduced or charged off, you may be required to repay these excess benefits at any time. Because this discrepancy may not be discovered for years, it's always a good idea to keep careful track of your medical expenses and reimbursements to ensure you don't inadvertently keep funds to which you aren't entitled. 

What should you do if you've received a repayment demand from your employer's workers' comp insurer?

If your repayment demand has followed on the heels of a personal injury settlement, you shouldn't need to worry -- your attorney will likely negotiate the repayment schedule and logistics on your behalf. However, if you feel you're wrongfully being accused of fraud or don't think you've received an overpayment, you'll want to seek legal counsel to sort out your options. Even if it is determined that you owe this money, your attorney can help you negotiate a lengthier repayment schedule or even a lower repayment amount that will help you fulfill this financial obligation without compromising your quality of life.

If you need help with a workers' compensation issue, contact a law firm like Hardee and Hardee LLP.


1 April 2016

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