DWC Adopts Rule 131.5 Pertinent to LIBs

Sec. 408.162 of the Workers’ Compensation Act provides that “[i]f a subsequent compensable injury, with the effects of a previous injury, results in a condition for which the injured employee is entitled to lifetime income benefits [LIBs], the insurance carrier is liable for the payment of benefits for the subsequent injury only to the extent that the subsequent injury would have entitled the employee to benefits had the previous injury not existed.”

And, importantly, “[t]he subsequent injury fund [SIF] shall compensate the employee for the remainder of the lifetime income benefits to which the employee is entitled.”

DWC has adopted Rule 131.5, effective February 18, 2025, that address the verification process for recipients of LIBs administered by SIF.

This new rule specifically applies only to SIF’s administration of LIBs and does not impose new requirements on insurance carriers. The verification process supports the appropriate allocation of SIF resources and helps maintain the integrity of the workers’ compensation system by preventing improper benefit payments.

The amendments require DWC to verify the continued eligibility of LIBs recipients receiving payments from SIF every month. This verification process ensures that only eligible individuals continue to receive benefits, supporting accountability and effective management of the SIF. Recipients can provide the required information through a telephone call, video call, or an approved online verification system.