Thursday, July 16, 2015

WORKERS COMPENSATION -- Late TTD Payments and the Insurer's Bad Faith


The workers compensation system, in theory, is designed as a quid pro quo where the injured worker gives up his/or her right of direct action against the employer in exchange for the promise that his/her work related injury claim will be covered by the employer's workers compensation insurance policy without question of fault.  The injured worker is also given preference toward re-employment with the employer after he/she has recovered from the injury.

In theory, this system should work to the benefit of both Parties.  The injured worker and the employer remain on equal footing, so long as they each give up an equal amount of 'legal leverage' to the other.  Unfortunately, the deck is stacked against the injured Montana worker.  Indeed, while the employee, in most instances, undertakes the process of the workers compensation claim on his/her own, the employer is armed with an experienced and (at best) thrifty insurance company who employs dozens, if not hundreds or thousands, of insurance claims adjusters who are trained to pay out the minimum amount of benefits necessary to resolve any given claim.  A Montana workers compensation adjuster employs a handful of 'panel defense counsel' who assist the adjuster in contesting various aspects of the claim.  Most often, relatedness of the injury to the employee's employment.


Indeed, from day one, the injured workers compensation claimant is at a significant disadvantage in having his/her claim handled quickly and fairly.  In order to reset the playing field EVERY injured Montana worker should consider hiring a workers compensation attorney.  If you have any questions regarding your rights under the Montana Workers Compensation Act, Matt Tourtlotte and the Tourtlotte Law Firm specialize in analyzing workers compensation claim, explaining the issues, and in upholding the rights of injured Montana workers and in helping them deal with difficult insurance companies.


One of the most common complaints I receive from the Montana workers compensation claimants who I represent is the late payment of benefits payable under the Montana Workers Compensation Act.  Among these, the late and/or non-payment of temporary total disability benefits (TTD) is the most common and injurious .  By statute, TTD benefits are payable every two weeks to the claimant by the workers compensation insurer.   In many instances this benefit only amounts to a partial payment of the lost wages the injured worker has suffered on account of his/her injury.  This is because the benefit rate is capped by statute at 66.6 % of the State of Montana's average weekly wage.  Presently, the benefit is maxed out at $708.00 per week, amounting to bi-weekly TTD payments of just over $1,400.00.

For those making less than $1,063.00 per week the bi-weekly TTD benefits are designed to amount to essentially the injured worker's bi-weekly pay amount less 33.3%.  The State attributes the 33.3 % reduction to taxes which would otherwise be withheld from the injured worker's gross wages. However, it is a far different and graver matter for the injured worker who was making more than $1,063.00 per week at the time of injury.  Indeed, by way of example, imagine an oil-field worker making $1,800.00 per week.  Because of the cap on TTD benefits, this claimant and others like him/her will be forced into a situation where they are required to live off of less than 50% of their time of injury weekly pay.  Even if the payments are made on time, it becomes near impossible for this claimant to pay the mortgage, the utilities, the auto loan, and to put food on the table for the family.

Now imagine that the insurer makes each of the required bi-weekly payments late, sometimes delaying the payment by more than a week.  The result is often disastrous, sending the claimant into extreme financial and emotional duress.   From medical bills being sent to collection to foreclosure notices from the bank, the insurer's refusal to pay benefits and/or to pay workers compensation benefits in a timely and consistent manner is a violation of the core principles of quid pro quo underpinning the foundation of the Montana Workers Compensation Act.  If this is happening to you, or a loved one, the insurer is committing insurance bad faith and is in violation of the Montana Unfair Trade Practices Act.  In order to protect your rights you should contact a workers compensation attorney who is experienced in the practices employed by insurers immediately.


Every workers compensation claimant deserves to be paid by the insurer on time.  It is imperative that these payments be issued in a prompt and timely manner by the insurer because, in so many cases, the injured worker has realized a considerable reduction in his/her pay.  Thus, the injured worker is already under considerable financial, emotional, and physical distress, long before the insurer is late with the benefit checks.  If you feel that your rights are being trampled upon, be sure to call an experienced attorney today.