GQ Corner
Q: Claimant’s accident was 1/1/2015. He was placed on light duty as of 1/2/2015. The insured was able to accommodate, but claimant was scheduled to be off until 1/07/2015 regardless; this was part of his normal schedule. Effective 1/05/2015 he was taken off work completely through 1/11/2015. Do I owe Temporary Income Benefits for 1/2/2015—1/4/2015, despite the fact he would have been off work any way just because of the way his schedule fell?
A: This scenario presents a fact question, meaning that the answer is not absolute. Since the claimant was taken off work on 1/5/2015 then more likely than not, a hearing officer would find disability for the period of 1/2/2015—1/4/2015. However, since the employer was able to accommodate the restrictions, the question arises as to whether a bona fide offer was made. If not, then it is going to be extremely difficult to prevail on those periods. However, if you do not reasonably believe that the claimant was disabled for the periods in question, then we recommend that you file a PLN 11 disputing disability. Your deadline for either paying or disputing is no later than the later of two events – (1) the 15th day following first written notice of the claimed injury or (2) the 7th day after the 8th day of disability.
Q: I have an injured worker who was given a per diem in the amount of $20 per day. I have another claimant who was given a company credit card as part of his employment, and was allowed to spend no more than $20 on that card for food each day. Would either or both of these scenarios need to be included on the DWC 3? Would either of these scenarios need to be added to TIBs?
A: The per diem needs to be included on the DWC 3 under gross earnings, since the claimant is actually given the money. The second scenario needs to be included on the DWC 3, but under the non-pecuniary section. The first scenario would always be included in your TIBs calculation. The second scenario would only be included if the employer revoked the credit card privileges after the injury.
FOLIO
