GQ Corner

Q. I have a claimant who is missing a few hours each week for physical therapy and follow-up appointments. Do I owe her Temporary Income Benefits for this lost time?

A. Yes, you would owe TIBs for the lost time in this scenario, as long as the PT and follow-up appointments are for the compensable injury.

Q. I initiated Temporary Income Benefits based upon an estimated Average Weekly Wage. 3 weeks into the payments, I received a DWC-3 with the true AWW, which was less than my estimated AWW. Is there any way to recover the overpayment?

A. Yes, Rule 126.16 provides for the recoupment of overpayments like your scenario. You must follow the Rule precisely and do not forget that the recoupment cannot begin until the second TIBs payment after notice is sent to the claimant. If the claimant is unrepresented, you may recoup 25% per week; however, if the claimant is represented, you may only recoup 10% each week.

Q. I have an injured worker who generally works in Texas, but was injured while on a business trip in Las Vegas. The injury is not in dispute, but would this be considered a Texas Claim or a Nevada claim?

A. It may be compensable in both Nevada and Texas, but because we handle Texas claims, I can only speak to the Texas aspect of this question. Texas Labor Code section 406.071 is the extraterritorial jurisdiction section and provides that an individual who is injured while working in another jurisdiction is entitled to Texas Workers’ Compensation benefits if:

(a) the injury would have been compensable in this state; and
(b) the employee had significant contacts with this state, or the employment is principally located in this state.

“Significant Contacts” is defined under this section as well: An employee has significant contact with this state if the employee was hired or recruited in Texas and the employee:
(a) Was injured not later than one year after the date of hire; or
(b) Has worked in this state for at least 10 working days during the 12 months immediately preceding the date of injury.

Since it sounds like the employee usually works in Texas, this claim will most likely be compensable under Texas law.