GQ Corner
Q: If the claimant calls to reschedule the designated doctor examination, may I suspend benefits until the examination takes place, as is the case with a missed examination?
A: You may not suspend benefits. Rule 127.25 is the applicable provision. Under that rule, the claimant may contact the designated doctor prior to the examination and reschedule. If the claimant does so, the carrier is not permitted to consider the examination missed without good cause and suspend TIBs.
Q: The claimant turned in her SIBs application 20 days late. Her attorney says she still qualifies for the full quarter, but we deduct the 20 days of SIBs from the amount due. I thought the penalty for filing a late application is the claimant does not qualify for any SIBs for that quarter—is that not correct?
A: The claimant’s attorney is correct. Under Rule 130.105, the late filing of the DWC-52 has the effect of relieving carrier from liability from the portion of the SIBs quarter up to the filing date.
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