Here is a pattern we see all the time. You get hurt, and within a few weeks the insurance carrier starts sending checks at your full, total disability rate. No hearing, no judge, no decision. It feels settled.
Then the carrier sends you to its own doctor for an independent medical examination. The doctor writes that you are only partially disabled, maybe 50 percent, maybe less. A few weeks later your checks shrink, or stop. Nobody held a hearing. No judge agreed. You may not even have been warned.
In many cases, that is allowed in New York. Understanding why, and what changes once a judge gets involved, is one of the most important things to know about your claim.
Voluntary payments come with no protection
When a carrier starts paying before the Workers’ Compensation Board has made any award, it is paying voluntarily. No one has ordered it to pay you, at any rate, for any length of time.
That means the carrier can reduce or stop those payments on its own. It does not need a judge’s permission first. What it must do is notify the Board on Form C-8/8.6, “Notice That Payment of Compensation Has Been Stopped or Modified,” and the law gives it until sixteen days after the change to do that. Board rules expect the notice to come with supporting evidence, and in practice that evidence is usually the IME report.
So a carrier that has been paying you at a total rate can cut you to a partial rate based on its doctor’s opinion, with nothing standing in the way except your response. We explain the related problem of payments stopping altogether in why your workers’ comp payments stopped.
Once a judge directs payments, the rules flip
Everything changes once a workers’ compensation judge makes an award at a temporary disability rate and directs the carrier to keep paying at that rate. Under the Board’s rule, 12 NYCRR 300.23, the carrier then cannot reduce or suspend your payments on its own. It has to:
- file a notice of its intention to reduce or suspend (Form RFA-2) with supporting evidence, such as an IME report, and
- wait for a hearing at which a judge finds the reduction is justified.
Until then, it must keep paying the rate the judge set. In 2025, New York’s Appellate Division confirmed that this holds even when the Board is slow to schedule the hearing: the carrier keeps paying the existing rate until a hearing actually happens and a judge rules.
There are narrow exceptions where a carrier may reduce or suspend on notice even after an award, for example if you have returned to work, or if your own doctor’s reports say you have no disability. But a disagreement between the carrier’s doctor and yours is not one of them. That disagreement is exactly what the hearing is for.
Why this matters so much
The difference between those two situations is the difference between the carrier deciding your rate and a judge deciding it. Voluntary checks at a total rate feel secure, but they rest entirely on the carrier’s continued cooperation, and an IME report is often all it takes to end that.
That is why, in many cases, it is worth getting your claim in front of a judge and getting an award with a direction to continue payments on the record, rather than coasting on voluntary checks. It is also why your own doctor’s reports matter so much: the judge sets the rate based on the medical evidence, and that includes a stated degree of disability from your treating doctor at every visit.
If your checks were cut after an IME
- Find the notice. You should receive a copy of the C-8/8.6. It states the reason and the new rate. Send it to your attorney right away.
- Get your own doctor’s report up to date. It should state your degree of disability as a percentage and explain why. A current report from your treating doctor is the strongest answer to an IME.
- Ask for a hearing. A reduction on a C-8/8.6 is not a decision. Your attorney can request a hearing; if you are unrepresented, see how to ask for a hearing.
- Challenge the IME. The carrier’s doctor’s opinion can be tested, including through cross-examination. See independent medical exams.
- Keep treating. A gap in treatment makes the carrier’s position look stronger.
- Do not wait. If the evidence supports your doctor, a judge can set your rate going forward and address what you were underpaid, but the sooner the issue is in front of a judge, the less you go without.
And if your attorney suggests agreeing to a rate lower than your doctor’s number, there can be good reasons for it. We explain them in why we might agree to a lower rate.
Frequently Asked Questions
Can the insurance company reduce my workers’ comp checks without a hearing?
Sometimes. If the carrier has been paying voluntarily, before any award by a judge, it can reduce or stop payments on its own and notify the Board afterward on Form C-8/8.6. Once a judge has made an award and directed continuing payments, the carrier generally cannot reduce them until a hearing is held and a judge finds the reduction justified.
My checks went from a total rate to a partial rate after an IME. Is that allowed?
It can be, if no judge has yet made an award directing continuing payments. In that situation the carrier may rely on its doctor’s report to reduce your rate. You can challenge it by getting a current report from your own doctor and asking for a hearing.
What is Form C-8/8.6?
It is the notice a carrier files when it stops or changes workers’ compensation payments it began without an award from the Board. It states the reason and the new rate. It is not a decision by a judge, and you can contest it at a hearing.
What protects my benefits from being cut without a hearing?
An award by a workers’ compensation judge at a temporary disability rate with a direction to continue payments. After that, the carrier must file a request with supporting evidence and wait for a hearing and a finding before it can reduce or suspend your payments, except in narrow situations such as a return to work.
Can I get back the money I lost when my checks were reduced?
Possibly. If a judge finds the medical evidence supports a higher degree of disability than the carrier paid, the judge can address the underpayment. The sooner the issue reaches a hearing, the better.
Talk to a New York workers’ compensation attorney
The Law Offices of Frank J. Dito, Jr. handles workers’ compensation claims from the office on Staten Island, for injured workers throughout the five boroughs and across New York State. If your checks were cut after an IME, call us before more weeks go by at the lower rate.
Call 718.701.2776 or 800.310.5520. Consultations are free. If we don’t recover money for you, we don’t get paid.
1610 Richmond Road #200, Staten Island, NY 10304
