GQ Corner
Q: Claimant has returned to work light duty, earning less than her pre-injury average weekly wage. The post-injury earnings fluctuate, and I receive an updated amount of post-injury earnings each week. My weekly payment was due on January 1, 2016, and I paid what I believed to be the correct amount of partial TIBs, but later discovered that Claimant’s post-injury earnings for that week was substantially less. Do I owe interest on the difference?
A: Yes. Rule 126.12 provides that interest is owed on all accrued but unpaid income benefits.
Q. If I have a claimant whose TIBs change from week to week based upon different amounts of post-injury earnings, do I have to file a PLN every time the amount changes?
A. Under Rule 124.2(e)(2), you are required to report increases in the TIBs amount based upon reduced earnings. There is no specific reporting requirement in the rule for decreases in TIBs based upon increased earnings, but according to the instructions on the form, you are required to file a PLN-8 (used to report a change in net income benefit payment amount (increase or decrease) to the employee/beneficiary/representative) for any actions that would normally trigger a Change in Benefit Amount (CA) transaction or an Reduced Earnings (RE) EDI transaction.
FOLIO
