Both entities paid me, what do I do ?

[Georgedroy]

First thing I really want to make clear... I'm not trying to "double dip", "screw the IC's", or anything like that. The last thing I need is to have my replacement wages (regardless of who they're coming from) jeopardized.

Ok... Long history, short synopsis (hopefully):

I had a "work injury", and was out on WC for over a year. Following that, I was working light duty (that met the conditions for my "work injury") for about a month, until my "home injury" took me out of work completely. The two injuries are completely unrelated to each other.

The "home injury" insurance company (I'll call them HOMIES) has been paying me LTD since my injury (aside from a couple of minor bumps). At the same time, my attorney, who was/is informed of my "home injury", and it's effect on my ability to work, has been filing with the "work injury" insurance company (let's call them WORKIES) to re-instate my WC wages.
My attorney is aware that HOMIES has been paying replacement wages. And in one notice to the court and my attorney, WORKIES stated that the claimant (me), "is currently being paid LTD benefits", so WORKIES is aware of what HOMIES is doing. WORKIES knows that HOMIES is paying me.
And HOMIES has, based on my medical records, has extended my LTD benefits thru xx/xx/xxxx (at least the next two months).

Yesterday I received a check from WORKIES from (roughly) starting date of LTD until current

If WORKIES knows that HOMIES is paying me LTD, then why is WORKIES sending me a check ? And what do I do with it ? I need to review my LTD contract, but what exactly should I be looking for ?
My employer is self-insured. I only mention that because I don't know if that fact is relevant or not...

Any thoughts, input and advice is greatly appreciated...

[1171]

it kinda depends on your state laws but generally...
comp has to pay; they are not allowed to offset by other coverages you may have.
private coverages can however ---depending on the contract.

yes, you need to review you LTD contract to see if it "includes" or "excludes" work comp payments.
it maybe a nice "windfall" for you! ----if it is "in addition" to work comp payments.

work comp can't offset because is would skew the loss cost amounts that are reported
and used to set comp rates i.e. a serious injury would be under-reported (hidden) if little or no TTD was reported.

[Georgedroy]

(02-16-2012 12:13 AM)1171 Wrote:  it kinda depends on your state laws but generally...
comp has to pay; they are not allowed to offset by other coverages you may have.
private coverages can however ---depending on the contract.

yes, you need to review you LTD contract to see if it "includes" or "excludes" work comp payments.
it maybe a nice "windfall" for you! ----if it is "in addition" to work comp payments.

work comp can't offset because is would skew the loss cost amounts that are reported
and used to set comp rates i.e. a serious injury would be under-reported (hidden) if little or no TTD was reported.

I'm in New York State...

The LTD carrier has been paying me replacement wages. My attorney has been petitioning for the WC carrier to pay at a "marked" rate (based on the WC doctor's latest report).

In a form dated roughly a month after the start of LTD, the WC carrier noted that the claimant (me) "is being paid for an unrelated injury by the insured".

And then the WC carrier sends me this check.

It's more than likley that I will have to (basically) give this check to LTD. What should I be looking for in my LTD contract ?
Any particular section ?

Any thoughts, input and advice is greatly appreciated...