Sample letter to claimants when converting benefits to supplemental earnings benefits

Dear ______________________ :

According to Dr.____________________, you have reached maximum medical improvement and have been released to alternative employment. Therefore, we are converting your benefits from temporary total disability to supplemental earnings benefits.

Pursuant to La.R.S. 23:1221(3) (f), enclosed are copies of form LDOL-WC-1020 from the Office of Workers' Compensation, Employee's Monthly Report of Earning. Kindly complete form 1020 for each month beginning in_________, 19____, for continued entitlement to worker's compensation benefits. If you have earned any income with an employer, or through self-employment, please indicate so on the form. Even if you have not earned any wages of any kind, it is mandatory that you complete the form and return it to us before we can issue your compensation check.

Should you have any questions regarding the completion of form 1020, please contact the undersigned.