GQ Corner

 Q: When I, as an adjuster, receive a child support order from the state for a particular claimant, how am I supposed to pay it? How much am I legally able to deduct from the claimant’s payments in order to satisfy the order?

A: The order of withholding specifies that part of lien is for current obligations and what part is for any arrearage. You will pay the lien out of any income benefits. The law requires you to pay up to 50% of weekly benefits to fund the current child support obligation and to pay up to 100% of benefits if the order is for the purpose of reimbursing accrued child support arrearage. So most orders will require that you pay 100% until the arrearage is satisfied. Once the arrearage is paid off you will pay up to 50% of the outstanding benefits to satisfy the current child support obligation.

Q: We received a client request asking if an employee would be eligible to receive both workers compensation indemnity benefits and unemployment benefits concurrently. Can you please advise?

A: Yes. The DWC has ruled in several appeals panel cases that receipt of unemployment benefits is not a bar to WC income benefits. The have also held that the these benefits do not constitute wages and do not affect the TIBS calculation.
However, the representations that the employee makes to the agency to apply of these benefits may be relevant if those representations are inconsistent with the Claimant’s assertions in the WC claim. This usually comes up if the employee is applying for SIBS asserting that they have no ability to work while also applying for benefits, asserting that they are willing and able to work.

Q: I have an employee who was goofing off at work when he was injured. He was attempting to slide down the hand rail of some stairs when he fell off, sustaining a head injury. Is there any way to deny this?

A: Yes. You can deny this under the “Horseplay” exception found in Section 406.032. A carrier is not liable if the horseplay was a producing cause of the injury.