GQ Corner
Q. A claimant refused a bona fide job offer on June 22, 2018 and it was signed by the claimant. A PLN-11 was not filed at that time and still hasn’t been filed. Do we owe TIBs until the PLN-11 is filed for disability?
A. No, you do not owe TIBs based on the filing date of the PLN-11. The stoppage date for TIBs, if the offer is a BFO, is the date the employee was directed to return to work, not earlier than the date the employee rejects the offer or the 7th day after receipt.
Q. I have a claimant who is scheduling all of his follow up doctors’ appointments during his work hours (he is currently working with light duty restrictions). He has now exceeded 7 days off work simply due to the fact that he has the doctor provide him a work excuse for missing work due to his doctor’s appointments.
I know in other jurisdictions claimants are to schedule their appointments outside of work hours, and we do not cover lost time due to doctor’s appointments aside from an IME.
What is the jurisdictional law regarding the same in Texas? Do I have to pay him lost time wages now due to his doctor’s appointments?
A. Yes. Texas does not require that doctor’s appointments occur outside work hours. If the claimant is losing time from work due to the appointments, then you count those days toward the accrual date.
Q. We have a claimant who has been overpaid for TIBs. I understand that it can be reclassified to IIBs at a later date.
Is there a rule that covers if the claimant is asking what to do with the check or if she wanted to return it to our office?
A. There is no specific rule about the claimant returning a check. She can do so and then you are square. Otherwise, if she cashes the check, you can re-designate that payment as IIBs later. Rule 126.16 governs overpayments and recoupment, and does not apply to re-designation of benefits.
She can just send you the check back and you can note the return and the fact that you have no overpayment.
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