• Claim numbers cannot be issued to attorneys who do not have a current copy of the declaration page of their insurance policy on file. If you have been notified that we are in need of an updated copy, please do so immediately.
• No work should be started on a claim before the claim number is issued. There are times when attorneys will find it hard to get a hold of our office due to large call volumes. Please feel free to request claim numbers through email (LST@deltafund.com).
• Claim numbers will only be issued to attorneys who have been approved by the Board of Trustees. When an attorney is approved under this Plan the approval does not apply to the whole firm. Each attorney in the firm will need to obtain their own approval before working on any claims.
• Claim numbers issued will be honored entirely regardless of what happens to the members benefits.
• The client must be the one who signs the form. If the spouse is the client, they must sign.
• Actual signatures are required, cannot be an electronic one.
• Claim forms must be completely filled out (all 5 sections). If the participant is unsure of any information (name of Local, previous claim information, etc.) please just have them put what they think it might be.
• If you are submitting statements from the 1st through the close of business on the 14th, payment will be issued on the 20th. If you are submitting invoices from the 15th through the close of business on the last day of the month, payment will be issued on the 5th of the following month. Please note, if the 14th of the month or the last day of the month falls on a weekend, the cutoff for invoices is the Friday before that weekend at 5pm PST.
• Invoices can be submitted at any time. You do not need to wait for the billing cutoff dates.
• Billing must be submitted monthly for any work done in the prior month. Do not wait for the end of the case before submitting billing. If something is preventing you from submitting the billing monthly contact out office so we can review any other options you may have.
• Any dates of service older than 180 days will be denied.
• All submitted billing must include your attorney code, claim number, transaction code, and clearly state which attorney completed the work. This can be done by putting the attorney initials next to each date of service or have a statement on the billing which states “All work completed by (attorneys name)”.
• Attorney initials must be printed or typed in. The initials are for the auditor to determine which attorney worked on the claim. They are not used for the attorney to verify they did the work.
• If the invoice is for a dependent of the member, both the member and dependent’s names must be listed on the billing.
• Any billing statements which include a date of service that is more than five days before the claim was opened will be automatically denied. This will apply to the whole claim, not just the dates of service that occurred before the claim was opened. If the dates of service occur five days or less before the date the claim was opened, the Fund Office will issue payment along with a warning to the attorney. The Fund Office will track these warnings and inform the Board of Trustees once this becomes a reoccurring issue for any attorneys.
• Attorneys shall accept the amounts reflected in the Schedule as payment in full for services rendered to eligible participants. Panel Attorney will look only to the Fund for payment, and will not seek payment, directly or indirectly, from any participant of any fee for services rendered under the Plan except for those items for which payment must be made by the participant as described in the Plan.
• Invoices can be faxed, emailed, or mailed. If they are emailed they must be sent to LST@deltafund.com.
• Cover sheets are not required. If you would like to attach a cover sheet for a record on your end as to what was submitted that is fine. Please know that we do not review this cover sheet and it is discarded.
• All filing fees must have a separate claim number. Fees reimbursed in 2019 must have a 2019 filing fee claim number issued. When billing for a filing fee, claim forms are not required; however, the following information must be included: the filing fee claim number, the date of service for when the fee was paid, and a description of what the fee is for. Claims submitted stating only “filing fee” without the required information will not be processed.
• Any fees covered under this Plan should be paid for by the attorney and billed to our office for reimbursement. These fees should not be paid by the member.
There are certain types of services that are not covered, even under general counseling. These are listed in the Summary Plan Description and the document which describes all of the transaction codes. If your office needs additional copies or has not received these documents, please contact our office. The most common prohibited services that the Fund Office comes across are:
• Cases where the participant is the landlord (they are only covered as tenants)
• Criminal cases other than criminal traffic (must also be a misdemeanor)
• Any business venture, or any other matter in which, for federal income tax purposes, the cost of legal service would normally constitute a business expense or a capital investment.
• Appeals of any decisions, judgments or orders of any administrative body or court of original jurisdiction.
• A judicial or administrative proceeding involving any of the following as an adverse party or potential adverse party: (a) any employer party to a collective bargaining agreement with the International Brotherhood of Teamsters or any of its affiliates, (b) the Plan or any agent thereof, (c) any employer that contributes to the Plan, (d) the International Brotherhood of Teamsters, or any other labor union, local or joint council affiliated with the Plan, (e) any health, welfare, pension or other fringe benefit trust, fund or plan, or the trustees, administrators or employees thereof, in which any labor union participates or has an interest.
• Travel expenses must be pre-approved by the Trust Fund office and have a claim number issued. Attorneys should normally not accept any cases where travel is required unless the participant is unable to obtain an attorney who is closer. Travel must be more than 35 miles one way.
• Transaction codes 445, 460, 465, 475, 480, 490, 495, 630, 820, and 822 have a litigation benefit available.
• Requirements for opening a litigation benefit:
A litigation benefit claim may be opened only when each of the following elements is satisfied:
1. A hearing, with witnesses, has been scheduled for a date after the litigation claim is opened, and
2. $1,000 or less remains to be billed on the underlying claim (e.g., three family matters) at the time the litigation benefit is requested.
• Documentation that must be retained in connection with a litigation benefit: When a litigation benefit has been opened, the Attorney must retain the following documentation:
1. A copy of the court order scheduling the hearing with witnesses (a trial setting order will not suffice), and
2. Actual preparation of witnesses for the scheduled hearing, or drafting of anticipated cross examination of adverse witnesses expected to testify at the scheduled hearing.
• Please note that if the Trust’s auditors determine that the required documentation is not in the Attorney’s file, the Trust may require that the Attorney reimburse any litigation benefits paid in that matter.