GQ Corner
Q. The employee is currently receiving TIBs due to the Employer being unable to accommodate restrictions. EE moved out of state on 9/5/2021. I sent him the name of one medical provider in his area. If the EE does not provide a work status report in a couple of weeks showing need for ongoing medical, can we file a PLN-11 to dispute disability?
A. Yes, but you cannot stop payments without more at this point. Refer to the last DWC-73 you have as it relates to the ending date of restrictions, then attempt again to get the claimant to the doctor for evaluation. If not, then request a DDR at least on disability, but the case would be ripe for DDR on MMI/IR. Of course, you could do that now even before disputing disability on a PLN-11.
Q. The injured worker was presented with an offer of modified duty from her employer on 9/09/2021. She rejected the offer immediately. Am I permitted to suspend TIBs as of 9/09/2021 or must I wait 7 business days?
A. Rule 129.6(g) states: “A carrier may deem the wages offered by an employer through a bona fide offer of employment to be Post-Injury Earnings … on the earlier of the date the employee rejects the offer or the seventh day after the employee receives the offer of modified duty unless the employee’s treating doctor notifies the carrier that the offer made by the employer is not consistent with the employee’s work restrictions.” You can suspend TIBs as of 9/09/21, the date of the employee’s rejection of the offer.
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