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  1. #1
    Join Date
    Jul 2018
    Posts
    115

    Default How are Retroactive TTD Benefit Calculated

    My question involves workers compensation law for the state of: ca

    My claim was denied within 20 days of my injury. I never received any benefits other than sdi. There was a period of unemployment but that has been taking care of.

    How is retro ttd calculated. I have all ptp reports showing ttd since eligible date. The first qme had me mmi in his supplemental report a year after I was injured but he noted his report that my mmi date is the same date of evaluation.

    The new qme says ttd and Iím not at mmi. Heís recommending treatment before he decides on impairment.

    Should there be retro ttd? If and when I get a rating, will the 15% increase apply?

    Thanks

  2. #2
    Join Date
    Feb 2008
    Posts
    1,145

    Default Re: TTD Benefit Noticed

    You need to take the whole situation and all communications/paperwork to a local attorney who knows his state WC laws and practices.

  3. #3
    Join Date
    Jul 2018
    Posts
    115

    Default Re: TTD Benefit Noticed

    Quote Quoting hr for me
    View Post
    You need to take the whole situation and all communications/paperwork to a local attorney who knows his state WC laws and practices.
    Got it.... I thought a forum was for discussion and questions.

  4. #4
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: How are Retroactive TTD Benefit Calculated

    We lack the information necessary to comment on your eligibility.
    Quote Quoting Fallguy
    View Post
    My claim was denied within 20 days of my injury.
    If your workers' comp claim was denied, then that's why you didn't get any workers' comp benefits (including TTD).
    Quote Quoting Fallguy
    I never received any benefits other than sdi.
    Your California SDI benefit would normally take the place of worker's comp benefit. You don't simultaneously get both.
    Quote Quoting Fallguy
    How is retro ttd calculated.
    As a general rule, TD benefits are set in the amount of two-thirds of the gross (pre-tax) wages that you lost while recovering from an on-the-job injury, but subject to a minimum and maximum weekly benefit amount defined by state law.
    Quote Quoting Fallguy
    Should there be retro ttd?
    We have no way of knowing, nor do we have any way of knowing if the net result of winning a WC appeal and getting TTD benefits will result in an offset of your SDI benefits that leaves you pretty much in the same situation you're presently in. You have told us nothing about any workers' comp appeal or its outcome.
    Quote Quoting Fallguy
    If and when I get a rating, will the 15% increase apply?
    If you are referencing Labor Code, Sec. 4658, relating to payments for permanent disability ("If, within 60 days of a disability becoming permanent and stationary, an employer does not offer the injured employee regular work... each disability payment remaining to be paid... shall be... increased by 15 percent.') This paragraph shall not apply to an employer that employs fewer than 50 employees."), that provision does not apply to temporary disability. If you are referencing Sec. 4658 (relating to termination of "regular work, modified work, or alternative work is terminated by the employer before the end of the period for which disability payments are due the injured employee"), you have not told us any facts that would suggest that you are qualified.

  5. #5
    Join Date
    Jul 2018
    Posts
    115

    Default Re: How are Retroactive TTD Benefit Calculated

    I appealed and my claim was accepted a few weeks ago. A few days later, I received a denial letter. They have accepted all doctors report and dates of ttd but will not pay benefits because I was terminated for cause.

    I didn’t think they can deny after 90 days if it’s not new evidence. The judge said ttd is medical and me being terminated is not why they are not paying benefits. He rescheduled the hearing and wants to see what qme says.

    The qme report is not out but he told me not to go to work until he sees mri. He said I needed physical therapy and more treatments. I’m just waiting for pain management doctor to schedule an appointment. He said he will discuss mmi after I finish my treatment.

    My next hearing is a month away so I don’t think the carrier will budge.

  6. #6
    Join Date
    Oct 2016
    Posts
    3,306

    Default Re: How are Retroactive TTD Benefit Calculated

    Fallguy would you either quit changing your story OR stop posting.

    You have, in multiple forums, said that you already have reached MMI, that the QME has been completed (two in fact).

  7. #7
    Join Date
    Jul 2018
    Posts
    115

    Default Re: How are Retroactive TTD Benefit Calculated

    Quote Quoting PayrolGuy
    View Post
    Fallguy would you either quit changing your story OR stop posting.

    You have, in multiple forums, said that you already have reached MMI, that the QME has been completed (two in fact).
    Is it possible to be mmi and ttd afterwords? You have to stop thinking negatively of me. The first qme had me as mmi. He retired. I have a new qme now.

    You also have to consider that I had zero knowledge of workers comp laws 2-3 months ago. Iím not sure why but I feel like thereís more people here trying to make me out to be a fraud more than actually helping.

    If youíve studied my earlier post, you may have skip the the post about me not asking any questions and trusting the Adjuster and HR put me in this position. They were able to manipulate documents and make things difficult. So Iím now having to ask a million questions to try and salvage this claim.

    Thereís enough information here for anyone to know where and what my claim is if you know how to use the internet.

    Iím curious to know the percentage of fraud on these forums vs actual injured workers. If it is fraud, what are there average time spent or questions asked. Iím not a detective but I donít think itís very wise to leave a trail if Iím attempting to fraud anyone.

  8. #8
    Join Date
    Feb 2008
    Posts
    1,145

    Default Re: How are Retroactive TTD Benefit Calculated

    Quote Quoting Fallguy
    View Post
    ....You also have to consider that I had zero knowledge of workers comp laws 2-3 months ago....
    again, you really need to talk to a local WC attorney. WC laws are very state and detail specific.

    Yes, fraud can be rampant in WC and you'd be surprised at those that come here wanting help to do so. I don't think you are trying to do so, but I will say you have probably gotten as much free advice and help as you are going to get without someone studying the very specific details of your case including all the timelines.

  9. #9
    Join Date
    Oct 2016
    Posts
    3,306

    Default Re: How are Retroactive TTD Benefit Calculated

    You were told LONG ago on many forums that you need a lawyer. You made up stories about not being able to find one that wasn't 3 hours away. You then said you had an appointment with one 3 hours away. You then said Bla blah blah.

    As someone that has dealt with hundreds of workers compensation cases from the employer perspective, I can tell you that WC lawyers are a dime a dozen. And the one with the least skill in your state would be better than you doing this on your own. If you couldn't get a lawyer to take your case. There can only be two reasons. 1. You don't have a case. 2. You speak to the lawyers as idiotically as you post on the forums. And I really doubt it is number 2.

  10. #10
    Join Date
    Jul 2018
    Posts
    115

    Default Re: How are Retroactive TTD Benefit Calculated

    Quote Quoting PayrolGuy
    View Post
    You were told LONG ago on many forums that you need a lawyer. You made up stories about not being able to find one that wasn't 3 hours away. You then said you had an appointment with one 3 hours away. You then said Bla blah blah.

    As someone that has dealt with hundreds of workers compensation cases from the employer perspective, I can tell you that WC lawyers are a dime a dozen. And the one with the least skill in your state would be better than you doing this on your own. If you couldn't get a lawyer to take your case. There can only be two reasons. 1. You don't have a case. 2. You speak to the lawyers as idiotically as you post on the forums. And I really doubt it is number 2.
    That wasnít made up. That attorney that was 3 hours away decline because I wanted to have ttd benefits to start instead of it being in the settlement. He couldnít guarantee that it will or can be done.

    I didnt say I couldnít find any attorney in town. I said Iíve been turned down by as many as 4-5 and at least 5 that never returned calls.

    There are several that is willing to take it, Iím just not real comfortable with them.

    To call a personís questions idiotic says quite a bit about your character. If I knew or know about workers comp, why would I waste me time trying to defend my claim here with people who Iíve never met. You could be the adjuster for all I know. Yet, I have nothing to hide because everything I said is the facts that I know.

    Iím not upset, I understand that you are frustrated because some or all of my questions might be difficult for you to understand.

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