September 28, 2014

Unilateral Suspension or Modification Upon a Return to Work

 

The unilateral Notification of Suspension or Modification was allowed in amendments to the Pennsylvania Workers’ Compensation Act in 1996. It is a very valuable tool for Pennsylvania workers’ compensation insurance adjusters because it allows a unilateral suspension or modification of the claimant’s benefits upon return to work instead of trying to secure the claimant’s signature on a Supplemental Agreement or Agreement for Compensation.

 Any time the claimant returns to work, a Notice of Modification or Notice of Suspension (LIBC-751) should be filed with the Bureau. If this document is filed within seven (7) days of the suspension or modification, the employer is entitled to an automatic modification or suspension of benefits. This document must be both filed with the Bureau and served on the claimant. This document can be filed electronically.

 It is important to note that the applicable time period is within seven (7) days of the suspension or modification itself. Many adjusters (and even attorneys) have come to believe that it must be filed within seven (7) days of the return to work itself. That is not the case. 34 Pa. Code § 131.50 notes that the form must be “provided to the employee, employee’s counsel, if known, and the Bureau within 7 days of the effective date of the suspension or modification of the workers’ compensation benefits.”

 By way of example, if the claimant returns to work on January 1, 2014, but the carrier is not notified until July 1, 2014, the carrier can still suspend the claimant’s benefits unilaterally so long as the adjuster files LIBC-751 to suspend the claimant’s benefits effective July 1, 2014, and the form is filed within 7 days of July 1, 2014. Simply, the form must be filed within 7 days of the change in benefits by the carrier.

 If the claimant does not file a challenge within 20 days of the Notice of Suspension/Modification, the suspension or modification is effective with the Bureau and the defendant/employer is liable only to pay the claimant modified benefits in the case of a Notice of Modification or no indemnity benefits in the case of a suspension. As a result, we strongly recommend that adjusters follow up with employers regarding returns to work and document those returns to work with appropriate notices of suspension and modification. The time period to issue the document is more reasonable than many think. Since there are so few ways to unilaterally affect benefits, diligent filing the LIBC-751 when appropriate should become a habit.