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Thread: Pd Delay

  1. #1
    Join Date
    Aug 2017

    Default Pd Delay

    My workers compensation claim was made in the State of: California
    what is a permanent disability delay letter?
    I received one in the mail.
    Does this mean my ttd payments stop?
    I have not reached 104 weeks of ttd yet.

  2. #2
    Join Date
    Oct 1971

    Default Re: Pd Delay

    It means the adjuster hasn't made a determination yet, he needs more time to investigate.
    That letter should explain what's going on - here's a good blog on this topic.

    There are many reasons for denying a workers’ compensation case and even more for delaying the determination.
    The “delay” letter will often tell you what information is necessary for the adjuster to determine whether your claim will be admitted or denied. It should state a reason such as, “I need to conduct an employer level investigation” or “I have no medical evidence that your injury is industrially related.” Since the adjusting agency is required to respond to your claim form promptly it is often easier to send out a delay letter than to conduct a real investigation.

    The delay letter should also inform you that you are entitled to up to $10,000.00 in medical care during the course of the investigation. It should tell you the date by which a decision will be made as to whether the claim is denied. That date should be no more than 90 days from the date the employer first knew of your claim. If a decision is not made by that time the claim is “presumed admitted.” Once a decision to deny the claim is made, your right to “up to $10,00.00 in medical care ends. It is important to note that a claims administrator or adjuster is required to conduct a “good-faith” investigation and not merely look for facts to justify a denial.

    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Aug 2017

    Default Re: Pd Delay

    Thanks Tony

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