GQ Corner

Q. May the carrier admit LIBs and initiate benefits without a hearing or agreement in place after stat MMI has been reached?

A. Yes, if the criteria is met. See Rule 131.1(a), which addresses the Initiation of Lifetime Income Benefits; and Notices of Denial

(a) The insurance carrier shall initiate the payment of lifetime income benefits without a final decision, order, or other action of the commissioner if an injured employee meets the eligibility criteria for lifetime income benefits listed under Labor Code §408.161 as a result of the compensable injury.

Q. Claimant has a light duty release from employer. They cannot accommodate the restrictions for his pre-injury job; however, there is another position that will meet the restrictions. There will be a reduction in post injury wages and could be a permanent position, if claimant likes it. They have offered for claimant to come into the office for a day or so to shadow someone already in that position to determine if he will take the position. Does the employer have to provide a bona-fide-offer of employment to claimant?

A. I would recommend that they do so just to be safe. If claimant later quits or retires, you will not be able to take credit for post injury earnings and thus pay partial TIBs unless there is a BFO in place.