I've got global hotkeys turned on and Always on top is turned on. Anyone know a fix?

it doesn't work at all or just when you have the game open?, if just in game see if it works with windowed/windowed fullscreen. also make sure 'Deactivate For Other Programs' is off too.

Yeah, LiveSplit can be pretty finicky about this. I suggest asking in the Speedrun Tool Development discord if you don't get anywhere > https://discord.gg/gCzBWE8V3z.