You refuse the job at your risk. An employer usually offers suitable alternative employment after having the job description reviewed by a doctor on their behalf or by your own doctor. An insurance company will probably file a petition against you in court if you refuse the job. A judge will review the job description as well as medical reports from your doctor and the insurance company’s doctor.  If the judge believes that you could have done the job, then he or she may enter an order allowing the insurance company to reduce your weekly compensation payment to what it would have been if you had accepted the job, i.e., weekly compensation will be reduced based on the difference between what you were paid in you regular job and what you would have been paid if you accepted the “suitable alternative employment” job.