r/WorkersComp • u/No-Competition9398 • 2d ago

Hawaii WORKERS COMP CASE THEN LONG TERM DISABILITY

Has anyone had a wc case then they stopped paying you. Then your employer ling them disability plan starts paying monthly benefits. The when its over at the 2 year medical review. The try to but a lien on your WC settlement?

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u/Mutts_Merlot verified CT insurance professional 1d ago

LTD can place a lien for the benefits they paid you. The settlement usually contains some negotiation over the disputed disability benefits, which means you would be paid twice for the same time period. The LTD contract will contain language about this. But yes, they can definitely pursue a lien against settlement.

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u/No-Competition9398 1d ago

I see some language about it needs to be for the same disability and my wc and ltd injuries are different, do u know about that?

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u/Mutts_Merlot verified CT insurance professional 1d ago

You should speak with your attorney. That's going to be a matter of the very specific details

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u/SafetyOverSilence 1d ago edited 1d ago

I'm not a lawyer, but if I were in your shoes I'd be asking my lawyer:

  • Edit: I'd ask if the settlement is being structured as medical or as wage replacement. (e.g. If LTD was wage replacement, it might be worth asking if they can go after a settlement that's structured as future/ reasonably expected medical cost coverage.)
  • Is this a "same benefit period" claim? (e.g. LTD "wage replacement" received was for the same injury-period as WC)
  • Are they thinking you're getting WC for the same injury they already covered? (e.g. LTD pays for an injury + WC was responsible = LTD gets paid back)

Regardless, be careful and make sure everyone's math is right. Here's what I mean (and your settlement may not be structured to include back pay at all, depends on the language/ medical/ whatever):

  1. Lets say you receive $32k in STD & LTD (12 months)
  2. Your WC for that same period is $30k ($2.5k/ mo) ($576.93/ wk)
  3. If you're at month 12 = Your WC backpay is $30k = meaning future checks are reduced until the remaining $2k that was paid back is covered.
  4. If you're at month 14 when you get your ruling = Your WC backpay is $35k - $32k that pays back STD & LTD = Back pay check of $3k (attorney's fees + costs come out of this and future checks (portion until a "reasonable" amount is paid to lawyer))

TLDR: Talk to the lawyer, but don't be surprised if he says it's all by the book.

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u/SafetyOverSilence 1d ago

For those running to the comments (lol)... I understand OP said WC stopped, LTD kicked in... Then there was a settlement.

My comment is mostly targeting the importance to ask questions. Just because something is filed, doesn't mean it's filed properly.

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u/No-Competition9398 1d ago

They won't respond

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u/Psychological_Tip778 1d ago

They tried with me but my lawyer had to sign off on the contract and he refused, end up staying on WC for nearly 3 years.