Q: The carrier accepted my claim been 30 days yet to pay any workers Compensation benefits ,
temporary totally disabled for a year I'm still under my doctor's care, will the Board access late fees. I've not received any letter regarding how much my benefits will be stalling tactics
If you are still qualified for temporary disability and the doctor has submitted the necessary forms/reporting to the insurance company, the insurance company must pay you an additional 10 percent of the payment, if the claims administrator sends a payment late.
This is true even if there was a reasonable excuse for the delay. However, there’s no penalty if the claims
administrator can’t determine, in the first 14 days after your employer learned about your injury, whether
TD benefits must be paid and sends you a delay letter. Have you received a delay letter?
You could be awarded a total of 25 percent of each late payment, up to $10,000, if there was no
reasonable excuse for the delay.
You should consult with a local attorney with workers' compensation experience.
A: TTD is due ONLY when a Physician on the carrier's Medical Provider Network writes you are Temporarily Totally Disabled (or a WCAB Judge finds you were TTD based on non-MPN doctor's findings). Are you seeing a doctor on the insurer's MPN yet? Has that MPN Doctor sent a report stating you are Temporarily Totally Disabled? Starting which date? There won't be any letter about your 'benefits' unless and until a physician on the insurer's MPN writes that you are TTD or PPD. IF an MPN Physician HAS written this and you can show the adjuster got a copy of this report, then yes penalties are due per LC4620.
Many injured workers expect the insurance carrier to do "the right thing" but most of the time they don't when it comes to an unrepresented injured worker... if they did then most of the reasons for having an attorney represent you in a workers compensation case would be unnecessary. Failure to pay you TTD would have your attorney filing a DOR ( Declaration of Readiness) for an Expedited hearing at the Workers comp appeals board and their would be a hearing before the court and the defense will have to answer why they haven't been paying you and if their answer is BS...
Your attorney will obtain an order for them to pay you plus any penalties or interest that has accrued.
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