Code of Massachusetts Regulations
452 CMR - DEPARTMENT OF INDUSTRIAL ACCIDENTS
Title 452 CMR 1.00 - Adjudicatory Rules of the Industrial Accident Board
Section 1.06 - Modification or Discontinuance of Compensation
Current through Register 1531, September 27, 2024
(1) Whenever the insurer or insured deems the employee to have refused to submit to, or in some way to have obstructed, a medical examination scheduled pursuant to M.G.L. c. 152, §§ 45 or 11 A, it shall be entitled to suspend weekly benefits without an agreement, order, or decision. Such a suspension of weekly compensation shall take effect only after the Department is notified on a form prescribed by the Department and when the insurer sends a written notice of the suspension to the employee and the employee's legal counsel, if any, by certified mail with a copy of the notice also sent to the department. Suspension cannot be commenced until the date the notice is mailed. Such notice shall state the grounds for the suspension and, except as to suspensions pursuant to M.G.L. c. 152, § 11 A, shall contain notification of the re-examination date. The re-examination shall be scheduled to occur not less than seven days nor more than 21 days from the date of notice of the suspension. Such notice shall also instruct the employee that attendance at, and cooperation with, the re-examination shall result in reinstatement of weekly benefits and payment of benefits withheld during the period of such suspension.
Should the claimant fail to appear at the re-examination, or in any way obstruct, or fail to cooperate at such re-examination, the suspension shall continue until an administrative judge makes a determination whether benefits should be forfeited.
(2) No suspension of benefits shall be allowed on the basis of an employee's failure to meet with a vocational rehabilitative specialist within the Department pursuant to M.G.L. c. 152, § 45 without the written authorization of the Office of Education and Vocational Rehabilitation.
(3) An insurer seeking to discontinue benefits in accordance with M.G.L. c. 152, § 35E shall file a complaint in accordance with the provisions of M.G.L. c. 152, § 7G. An insurer may not unilaterally discontinue benefits under M.G.L. c. 152, § 35E.
(4) An insurer, without the requirement of an order under M.G.L. c. 152, § 10A, may suspend or take credit for any compensation due to the extent of any excess retained by or paid to an employee in connection with a settlement approved in accordance with the provisions of M.G.L. c. 152, § 15.
