GQ Corner

Q. If we have an overpayment, can we reduce the claimant’s income benefits by 10% and keep reducing by 25% for attorney fees for a total of 35% reduction?

A. Yes. Rule 126.16 permits you to recoup up to 25% of the claimant’s benefits when they are not concurrently being reduced for payment of attorney’s fees; or up to 10% of the claimant’s benefits when they are concurrently being reduced for attorney’s fees. In your case, if you follow the requirements of Rule 126.16, you may reduce (recoup) the claimant’s income benefits at 10% per week.

Q. We are paying TPD.  If the plant was closed, are we required to pay ongoing partial benefits as the employer had been accommodating?

A. If the claimant was disabled (earning less than the full pre-injury wage because of the compensable injury) when the plant closed, you would still owe ongoing TIBs because the compensable injury would presumably remain a cause (even if not necessarily the only cause) of reduced wages.

1. 1. 1. Conversely, if the claimant was not disabled because the employer was accommodating restrictions while providing full pre-injury wages when the plant closed, you could dispute disability/entitlement to TIBs because the compensable injury would not appear to be a cause of reduced wages.
      2. Probably a simpler way to look at it would be to say that if you were already paying TIBs when the plant closed, you presumably owe ongoing TIBs (and indeed full TIBs if the claimant has no post-injury earnings) throughout the pendency of its closure unless and until the claimant reaches MMI and/or you develop an independent disability defense.