Section 7-2 - Benefit Suspension, Limitations and Discounting (a) Failure to Appear for Medical Appointment. TTD benefits shall be suspended if the worker fails to appear and cooperate in any examination or testing at an appointment with his health care provider(s), or one scheduled by the Division. Payment shall be suspended until such time as the worker appears at a subsequent rescheduled appointment. Payment will not be suspended if: - (i) The worker notifies the Division prior to the appointment or within 24 hours after missing the appointment. The worker should call his claims analyst at the claims analyst's direct number and leave a message if the claims analyst is not available;
- (ii) The Division determines that the worker made all reasonable efforts to appear at the appointment.
(b) Limitation on Period of Temporary Total Disability (TTD); Extraordinary Circumstance. - (i) The period for receiving a TTD award under W.S. § 27-14-404 resulting from a single incident, accident, or period of cumulative trauma or exposure shall not exceed a cumulative period of 24 months, except that the Division, in its discretion, may award additional TTD benefits if the claimant establishes by clear and convincing evidence that the claimant:
- (A) Remains totally disabled, due solely to a work-related injury;
- (B) Has not recovered to the extent that he or she can return to gainful employment;
- (C) Reasonably expects to return to gainful employment within 12 months following the date of the first TTD claim occurring after the expiration of the 24-month period;
- (D) Does not have an ascertainable loss which would qualify for benefits under W.S. §§ 27-14-405 or 406;
- (E) Has taken all reasonable measures to facilitate recovery, including compliance with the recommendations of the treating physician.
(c) Discounting of Lump Sum Payments. Pursuant to W.S. § 27-14-403(f), awards to an injured worker or an injured worker's spouse for PPD, Permanent Total Disability (PTD) or death, or any part of such awards, may be discharged by the payment of a lump sum if the Administrator determines that a lump sum payment is justified by exceptional necessity. All lump sum payments shall be discounted using a discount factor determined by the State Treasurer's Office, based upon the average rate of return on the Division's investments for the prior fiscal year.