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

MONTANA WORKERS COMPENSATION

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.

HIRE A MONTANA WORKERS COMPENSATION ATTORNEY

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.

LATE PAYMENTS OF BENEFITS

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.

HOW TO OBTAIN HELP

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.

ADDING INSULT TO INJURY...

Montana Auto Accident:

Who exactly is taking care of you or your loved one when you are admitted into the hospital? Obviously your first response to this question would be "the doctor", "the nurse", "physician's assistant", etc.  Each of these persons, as well as other professionals, are routinely involved during a patient's stay at a medical facility.  But who is this person from Cardon Outreach or Continum who has been stopping by the hospital room every half hour?  What are all these documents they are trying to get you to sign?  Who do they work for...Is this person from Cardon Outreach even part of the hospital staff?  

Montana Personal Injury:

If you or your loved one has been visited by a "Patient Advocate" from Cardon Outreach or Continuum, my two cents is that you kindly ask them to leave you alone and call someone for legal advice immediately.  It turns out that if you are being visited by one of the Cardon Outreach or Continuum 'Patient Advocates', you have unfortunately been in an automobile accident.  These companies and the individuals who represent them are trying to get information from you so they can make claims against your insurance coverage and/or against insurance coverage that would otherwise compensate you for future medical expenses, pain and suffering, lost future income, and other damages you may have incurred on account of the automobile accident.   Once you give your personal and insurance information to the representatives of Cardon and/or Continuum, it appears they and the hospital facility to which you are admitted will do everything they can to avoid submitting your hospital bills to your health insurance carrier.

Billings Accident Attorney:

Tourtlotte Law Firm has received several complaints from clients who have been approached and harassed by representatives from these firms.  It has been reported that 'Advocates' from Cardon and/or Continuum will camp outside the hospital patient's room, waiting for an opportunity to introduce themselves as a 'Patient Advocate', there to "help" get the patient's hospital bills paid. Other reports have stated that these firms encourage and/or advice hospital patients that they do not need to seek the advice of legal counsel. Indeed, it appears that some patients are being approached by these 'Advocates' while they are most vulnerable, often times under the influence of medications that have been prescribed in relation to severe injuries sustained in an automobile accident.  

If you or a loved one are involved in an auto accident and are admitted to the hospital, rest assured that you will be receiving a visit from a representative of Cardon and/or Continuum.  When this happens, proceed with caution.  If you are asked to sign any documents, take time to read the document and decide whether or not the 'Patient Advocate' is acting in your best interest.  If there is any doubt in your mind, feel free to call me, Matt Tourtlotte, at the Tourtlotte Law Firm immediately, (406) 294-3400 or email Matt Tourtlotte at attorney@tourtlottefirm.com. 

Waiting to talk to an attorney could cost you and your family tens, if not hundreds of thousands of dollars.  More importantly, providing information to and/or signing paperwork provided by the ‘Patient Advocates’ of Cardon and/or Continuum could result in your medical bills not being billed to your health insurance carrier and ultimately, to collection actions being taken against you. 

After A Month On My Own

July 28, 2014:

The Tourtlotte Law Firm has been open for a little more than a month now.  When the doors opened in June it was, and has been, busy non stop.  Special thanks to my wife for all of the work she has done to get the law firm up and going.  We couldn't have done this without her considerable expertise and help.

I've enjoyed the new office and the new work tremendously.  Every day seems to bring a new challenge and new excitement.  It has given me new purpose in my career to work toward helping those people who need the assistance of a good lawyer.  I hope that's what people find when they find Matt Tourtlotte at the Tourtlotte Law Firm, PLLC.(tourtlottelawfirm.com), a good lawyer, dedicated to helping the people who live, work, and play in the great state of Montana.

-MIT