Could Macy’s Worker who Kept Getting TTD after RTW Keep $1,369 ‘Overpayment?’

What Do You Think?

A case involving a Macy’s worker who received more benefits than she was entitled to highlights the importance of monitoring workers’ compensation claims. It also sheds light on what constitutes an “overpayment” in West Virginia.

The Macy’s employee in that case was injured at work in August 2022 and received temporary total disability benefits. She finally returned to work on May 9, 2024. But the checks kept coming. 

The Macy’s Santa that was continuing to send her money she was no longer entitled to was the claims administrator. Seems the administrator, focused on other duties, may have failed to monitor the claim. As a result, the claimant received an extra $1369  – perhaps enough, in this economy, to buy her something nice from the sock department.

The claimant’s attorney emailed the administrator that his client was back at work but still receiving benefits. That same day, the administrator issued an order declaring an overpayment, after May 8, 2024, in the amount of $1,369. She told the claimant that the overpayment would be deducted from future benefits until it was paid in full. The claimant wasn’t too happy about that.

The workers’ compensation board reversed the administrator’s decision and Macy’s appealed.

On appeal, the court explained that under West Virginia Code § 23-4-1c(h), an overpayment of TTD benefits arises if two things occur:

1. An employer files a timely objection to an order denying its request to modify benefits; and
2. An adversarial proceeding results in an order finding that the claimant was not entitled to the benefits. 

Could Macy’s get its $1,369 back?

A. Yes. It wasn’t fair for the claimant to get the extra money.

B. No. The administrator did not terminate benefits until May 29.

If you selected B, you agreed with the court in Macy’s Corp. Servs., Inc. v. Wolford, No. 25-ICA-48 (W. Va. Ct. App.  08/06/25), which held that Macy’s could not retroactively terminate benefits.

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The intent behind § 23-4-1c(h), the court stated, is that once a work-related injury has been ruled compensable and a claimant has been awarded TTD benefits, the claimant continues to receive these benefits until the employer (or it its representative) properly seeks to modify or terminate that award.

Here, neither the administrator nor Macy's timely sought to terminate the benefits. The administrator had a duty to monitor the claim “but inexplicably sent Ms. Wolford additional benefits between May 9, 2024, and May 29, 2024,” the court remarked. 

The administrator only acted after the claimant’s lawyer contacted her, and she was not entitled to retroactively terminate the payments. The proper date for cessation of benefits was therefore the administrator’s May 29 termination order. 

Because the administrator did not terminate the benefits prior to that date, she could not seek to recover the money paid from May 9 to May 29 as overpayments.

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