GQ Corner

Q:        I have a claimant who sent me request for travel reimbursement and meals.  There were no receipts attached to the request and he just put a dollar amount of $46.00 on all of them.  I responded and requested receipts or copies of receipts needed for reimbursement. He responded that when he spoke with the State, they said reimbursement was a flat rate per day. He informed me the State didn’t tell him that he needed to keep receipts. He also said that they said that they had done away with travel receipts.  Is this correct?

A:        That is not correct—the DWC 48 specifically states the claimant must submit receipts for lodging and meals. What he’s probably conflated is that the reimbursement cannot exceed the maximum rate for state employees, which was $46 up through September 30, 2015. The max rate was increased to $51 as of October 1, 2015. You can find additional information regarding the state rates at:

            https://fmx.cpa.state.tx.us/fmx/travel/textravel/rates/current.php

Q:        We initiated TIBs as of 5/24/16 and have continued to pay TIBs on a weekly basis at the maximum rate of $850. We initiated because light duty was no longer available. However, claimant is also collecting paid time off. Can the claimant collect TIBs and PTO at the same time?

A:        We need to know how the insured’s PTO works so we can determine if the PTO constitutes post injury earnings (PIE). If the PTO is PIE, then the post injury earnings are subtracted from the pre-injury AWW with the carrier paying 70 % of the difference. However, if they are not post injury earnings, then they cannot be used to reduce the claimant’s TIBs rate.  Rule 129.2 identifies what is and is not pie. With respect to accrued sick pay and accrued annual leave, the question is whether the claimant voluntarily elected to use them or not. If he is using the time voluntarily, the PTO is PIE.  If it’s not voluntary, it isn’t PIE. If the PTO is actually salary continuation, that is also PIE.