GQ Corner

Q. The IW was released to light duty with restrictions by her treating physician.  She signed a Bona Fide Offer of Employment agreeing to work 40 hours per week.  She is also on FMLA for her on the job injuries.  The FMLA paperwork was signed by her personal doctor and at this time, we do not have any medical from this doctor.  The IW is using FMLA for her on the job injuries.  At this time, we have no medical to support appointments or anything documenting why she needs the time off.  Since she signed the BFOE, do I owe TIBs for the time off under FMLA?  

A. Because the claimant signed the BFOE, then you may continue to treat the offered wages as post-injury earnings. If the post-injury earnings are the same or more than the pre-injury AWW< then you will not owe TIBs. If the offered wages are less than the pre-injury AWW, then you would owe partial TIBs. This is true so long as you do not receive medical documentation taking the claimant off of work completely for her compensable injury. 

Q. If the treating physician signs the DWC-69 completed by a post DD RME certifying MMI, does this give the report any additional weight?  Also, if the DD finds that claimant has not reached MMI and is not expected to until 10/20/2019 and the RME backdates MMI, may the carrier file the DWC-69 as the initial certification?  Claimant is not currently receiving TIBS. 

A. The treating doctor’s signature on the RME certification gives it additional weight, and it is something we often argue at the CCH. If the DD deferred MMI, and the post-DD RME certified the claimant at MMI, I recommend that you send that certification to the claimant via verifiable means. This will be the first certification of MMI and IR, subject to finality. Whether you can pay pursuant to the post-DD RME’s certification is another question, which I am unable to answer without knowing the date of the DDE, the date of the post-DD RME, and the MMI date certified by the post-DD RME.