Texas Workers' Compensation

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§ 130.11. Agreement for Monthly Payment of Impairment Income Benefits

(a) Upon the request of the injured employee, the insurance carrier and an employee entitled to impairment income benefits (IIBs) may agree to change the frequency of IIBs payments from the standard weekly period to a monthly period. The agreement to change the payment frequency must be in writing and is only required to be filed with the Commission if the Commission requests a copy. To relieve the insurance carrier of the responsibility to pay IIBs weekly, a valid written agreement must include the following terms and conditions:

(1) the agreement for the monthly payment of IIBs payments shall be effective the first calendar day of the month following the month in which the written agreement was entered into by the insurance carrier and the injured employee;

(2) monthly IIBs payment shall be issued on or before the seventh day of the month for which benefits are due;

(3) weekly IIBs payments shall continue through the end of the month in which the agreement was signed.;

(4) payment of the last week of IIBs to transition from weekly payment of IIBs to monthly payments shall be prorated to the end of the month to ensure the injured employee receives IIBs through the last day of the month;

(5) if less than the maximum weekly compensation rate in effect on the date of the compensable injury is being paid, a completed Employer’s Wage Statement must be included with the injured employee’s copy of the written agreement;

(6) the monthly benefit amount shall be equal to the weekly compensation rate for IIBs that the injured employee is entitled to multiplied by 4.34821; and

(7) the impairment rating and source of the impairment rating upon which payment of IIBs is being based.

(b) An injured employee and insurance carrier may not agree to the monthly payment of IIBs until the impairment rating has been agreed to or has become final. The entering into an agreement under this section may not be used for the purpose of finalizing an impairment rating

(c) The agreement for the monthly payment of IIBs shall expire upon the suspension or termination of IIBs in accordance with the Act and Commission rules. The last monthly payment shall be prorated to ensure the insurance carrier pays the appropriate amount of IIBs.

(d) At any time after signing the agreement for the monthly payment of IIBs, the injured employee or the insurance carrier may notify the other party in writing that it no longer agrees to the monthly payment of IIBs. In this case, the insurance carrier shall pay all accrued but unpaid IIBs at the end of the current monthly cycle and shall continue paying IIBs weekly as and when they accrue and are due.

(e) Effective Date. This section applies only to agreements entered into on or after January 1, 2000, for payment of IIBs under the provisions of the Act.

The provisions of this § 130.11 adopted to be effective December 26, 1999, 24 TexReg 11447.

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At a Glance:

Title:

§ 130.11. Agreement for Monthly Payment of Impairment Income Benefits

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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