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  1. #1
    Join Date
    Sep 2008
    Posts
    32

    Default How to Prove Not Receiving TTD

    I have been out off work for work related illness since Nov 3, 2008. I have received 10 weeks of TTD total with the last check date ending on Feb 16, 2009. I applied for LTD benefits though my retirement plan. They sent a letter back saying I need to provide proof that I am no longer receiving TTD, as well as MMI date and % of disability. I have not been determined MMI but they have failed to pay TTD. I requested assistance from DOL months ago but have not received a ruling or anything leading me to believe I will receive TTD.

    The question is: How would I go about getting the IC to provide proof they are not paying me TTD? I do have an attorney for WC and I sent him an email but I don't know if he can/will help me applying for LTD. They have only given me 30 days to provide proof or they will drop my application so I was wondering if anyone here can tell me what I need to do.

    thanks for your help,
    Voyager_91

  2. #2
    Join Date
    Mar 2009
    Posts
    289

    Default Re: How to Prove Not Receiving TTD

    Is your attorney trying to get your TTD reinstated?? If your not MMI and % was not given, you need to let your LTD know, because if these are things you need to collect LTD there would be no need to worry about getting the TTD letter. But depending on all the answers to the questions, if all else fails you could get a hold of the state to help you. But if you have an attorney, you should be discussing this with him first. Good luck and take care.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,945

    Default Re: How to Prove Not Receiving TTD

    I applied for LTD benefits though my retirement plan. They sent a letter back saying I need to provide proof that I am no longer receiving TTD, as well as MMI date and % of disability.
    Did you read the exclusions of the LTD policy. Most don't provide benefits for a work related injury.
    If you are MMI/rated, and your doctor continues to certify you cannot RTW... then the LTD benefits might be paid on a non-industrial basis.

    And IF this one does, they want the proof of your status so they can take the offset based on the TTD.
    Didn't you receive a letter from the CA telling you TTD was ending, and why?
    Was there a doctors/IME report that says you are no longer temporarily disabled ? That would be a reason for the TTD to stop, even though you may not be MMI and rated yet. That letter could probably be used to show LTD carrier you are no longer TTD.

    They have only given me 30 days to provide proof or they will drop my application
    Ok...then you just apply again, that's all. But read the policy where the exclusions of coverage are discussed.

  4. #4
    Join Date
    Sep 2008
    Posts
    32

    Default Re: How to Prove Not Receiving TTD

    My policy states the amount received for disability caused by a work related injury will be pro rated to offset any workman's comp payments.

    I never received anything from the CA. I had to enlist the DOL to get the ten weeks TTD I did get but have received nothing since then.

    I am not MMI, still receiving treatment and the doctor still cerifies I am TTD however the IC has failed to pay the doctor's bill or TTD and I am paying the doctors bills as well in order to continue to receive treatment. My attorney requested assistance from the DOL for both the TTD and medical bills but the only response I got was a letter stating the request was received by the DOL and the name of the person who is "looking into the situation"

    Reapplying is not as simple as it sounds. There is a time period of 180 days from the last date of work to apply. I kept thinking the DOL would help me so I waited to apply. If I was receiving TTD then that time frame would be taken into account but since I am not I am pretty sure the February 16, 2009 date of my TTD is when the 180 days began. I don't know what effect them dropping would have on the timeframe, if any.

    Can you tell me what the form name or number is I should have received from the CA? Maybe if I request that form specifically I will get somewhere.

    thanks,
    Voyager_91

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,945

    Default Re: How to Prove Not Receiving TTD

    Can you tell me what the form name or number is I should have received from the CA? Maybe if I request that form specifically I will get somewhere.
    Don't know. Don't know IF there is an actual form.
    Some/most states have regs that require the ER/IC to provide a notice of benefits, whether they are stopping, starting, changing etc. Your atty should have info on those rules, and following up for/with you.

    What you/AA requested from the DOL is likely a hearing on the matter of your benefits/TTD being stopped. It will no doubt take a hearing/mediation to get a judge or order those benefits reinstated.
    Takes time... like any issue subject to litigation.

    My policy states the amount received for disability caused by a work related injury will be pro rated to offset any workman's comp payments.
    Ok. Most LTD policies pay a % of your average weekly wage, like comp.
    So say your LTD pays 80%, comp pays 66%, LTD will pay the difference between the two. That is the reason they are asking for proof one way or the other of what your status is. I don't know why the CA for the LTD carrier couldn't just request a status letter from the comp IC....I also don't know how one could 'prove' that comp/TTD benefits are NOT being paid. It's easy enough to prove you ARE receiving benefits... strange they/LTD asks for proof you are not.

  6. #6
    Join Date
    Sep 2008
    Posts
    32

    Default Re: How to Prove Not Receiving TTD

    Thank you for all your help, BvIA

    My attorney says he is requesting a copy of the form submitted to the DOL from the IC which should show TTD status. Meanwhile I am going to call the LTD CA Monday and ask if there is a form they are expecting to be completed or how to go about proving I am not receiving TTD.

    The CA for LTD does not request any paperwork from anyone just sends the claimant a list of what must be submitted to complete the claim. If you fail to submit the paperword requested then the claim is dropped. I went to each of my doctors and got copies of my medical records and requested the doctor feel out the medical statement required to complete the application.

    I understand the LTD will probably only pay the difference between the 66% TTD is suppose to pay and the 80% max but 14% of my pay is more than I am getting now from anyone.

    If I apply for public assistance, are they going to count the phantom 66% WC is suppose to pay? Right now child support is our only income.

    thanks,
    Voyager_91

  7. #7
    Join Date
    Sep 2008
    Posts
    32

    Default Re: How to Prove Not Receiving TTD

    I have seen several posts on this website about wc cases being public records. Can anyone tell me where to find those records? Will those records show current status? Since I have not received TTD nor have they paid my medical bills since February, maybe this record will show reflect that.

    Any information is appreciated,
    Voyager_91

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