Texas Workers' Compensation

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§ 137.42. Definitions

The following words and terms shall have the following meanings only for the purposes of the return-to-work reimbursement program for employers:

(1) Allowable expense–An expenditure of funds, costs incurred, or costs that will be incurred by an eligible employer for workplace modifications or other costs that are necessary to reasonably assist an injured employee’s doctor-identified restrictions that are intended to facilitate the early and sustained return to work of an employee who has a compensable injury. An indemnity benefit, medical benefit, or health care for which an insurance carrier is liable is not an allowable expense under the program.

(2) Applicant–The employer requesting funds from the return-to-work reimbursement program.

(3) Application–The return-to-work reimbursement program application provided by the division for reimbursement, preauthorization, or advancement of funds used or proposed to be used by employers for workplace modifications.

(4) Alternative duty–Job duties that are different from the injured employee’s normal or regular pre-injury job duties and that are assigned specifically to facilitate the injured employee’s doctor-identified work restrictions or limitations.

(5) Eligible employer–Any employer that:

(A) is not a state agency or political subdivision of the state;

(B) employed at least two but not more than 50 employees on each business day during the preceding calendar year; and

(C) has workers’ compensation insurance coverage in Texas.

(6) Division–The Texas Department of Insurance, Division of Workers’ Compensation.

(7) Modified duty–The injured employee’s normal or regular pre-injury job with workplace modifications to facilitate doctor-identified work restrictions or limitations.

(8) Return-to-work reimbursement program (program)–The division’s program for the reimbursement, preauthorization, or advancement of funds to eligible employers for allowable expenses which facilitate the early and sustained return to work of an employee who has a compensable injury.

(9) Return-to-work reimbursement program administrator (administrator)–The administrator of the Texas Department of Insurance, Division of Workers’ Compensation return-to-work reimbursement program for employers.

(10) Single employer–An employer operating one or more businesses under the same federal employer identification number. In the absence of a federal employer identification number, a single employer is established by the employer’s social security number.

(11) State appropriation year–The State of Texas’ fiscal accounting year that begins September 1 and ends August 31 of the following year.

(12) Workplace modification–Physical modifications to the worksite; equipment, devices, furniture, or tools; or other reasonable costs necessary to facilitate an employee’s return to restricted, modified or alternative duty.

The provisions of this §137.42 adopted to be effective February 22, 2006, 31 TexReg 1037; amended to be effective April 25, 2010, 35 TexReg 3061.

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At a Glance:

Title:

§ 137.42. Definitions

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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