PJC General Negligence 2024

W ORKERS ’ C OMPENSATION —S UPPLEMENTAL I NCOME B ENEFITS

PJC 24.1

PJC 24.1 Supplemental Income Benefits Entitlement (Comment) Supplemental income benefits (SIBs) provide long-term disability compensation. They become payable upon termination of the impairment benefits if the claimant has an impairment rating of 15 percent or more and has not returned to work or has returned to work and is earning less than 80 percent of his preinjury average weekly wage as a direct result of the impairment. Tex. Lab. Code §408.142; see also Texas Workers’ Compensation Commission v. Garcia , 893 S.W.2d 504, 514 (Tex. 1995). Other criteria for entitlement to SIBs are that the claimant has not elected to com mute a portion of the impairment income benefit under Tex. Lab. Code § 408.128 and has demonstrated an active effort to obtain employment in accordance with Tex. Lab. Code § 408.1415. Tex. Lab. Code § 408.142(a). Tex. Lab. Code § 408.1415 directs the Commissioner of Workers’ Compensation of the Texas Department of Insurance (DWC) to adopt compliance standards that define an active job search effort. To sat isfy this obligation, the commissioner adopted 28 Tex. Admin. Code § 130.102 (Rule 130.102). That rule applies whether the award of SIBs is made by the DWC or by the court. See Tex. Lab. Code § 408.141. Accordingly, some of the questions and defini tions in this chapter are derived from Rule 130.102. SIBs are adjudicated and paid on a quarterly basis. An employee’s entitlement to SIBs is determined retrospectively and paid prospectively. An employee’s active job search must take place during each week of the qualifying period for the quarter in dis pute. The qualifying period is a thirteen-week period that begins fifteen weeks before the thirteen-week SIBs quarter in dispute starts. The last two weeks of the fifteen-week period is the “filing period,” during which the employee documents his efforts, com pletes an application, and files that application with the insurance carrier. The DWC, rather than the court, will calculate the applicable beginning and ending dates for each disputed SIBs qualifying period or quarter. The statute and rules produce a scheme under which the jury must evaluate an employee’s job search efforts during each thirteen-week qualifying period in order to qualify for benefit payments during each subsequent thirteen-week compensable quar ter. Questions, definitions, and instructions should use the beginning and ending dates determined by the DWC for questions concerning an employee’s efforts during each qualifying period for any particular disputed SIBs quarter.

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