Current through all regulations passed and filed through September 16, 2024
(A) The following provisions shall apply to
all claims where the date of injury or the date of disability in occupational
disease claims accrued on or after August 22, 1986. The following definitions
shall be applicable to this rule:
(1)
"Maximum medical improvement" is a treatment plateau (static or
well-stabilized) at which no fundamental functional or physiological change can
be expected within reasonable medical probability in spite of continuing
medical or rehabilitative procedures. An injured worker may need supportive
treatment to maintain this level of function.
(2) "Physical capabilities" includes any
psychiatric condition allowed in a claim.
(3) "Suitable employment" means work which is
within the employee's physical capabilities.
(4) "Treating physician" means the employee's
attending physician of record on the date of the job offer, in the event of a
written job offer to an employee by an employer. If the injured worker
requested a change of doctors prior to the job offer and in the event that such
request is approved, the new doctor is the treating physician.
(5) "Work activity" means sustained
remunerative employment.
(6) "Job
offer" means a proposal, made in good faith, of suitable employment within a
reasonable proximity of the injured worker's residence. If the injured worker
refuses an oral job offer and the employer intends to initiate proceedings to
terminate temporary total disability compensation, the employer must give the
injured worker a written job offer at least forty-eight hours prior to
initiating proceedings. The written job offer shall identify the position
offered and shall include a description of the duties required of the position
and clearly specify the physical demands of the job. If the employer files a
motion with the industrial commission to terminate payment of compensation, a
copy of the written offer must accompany the employer's initial
filing.
(B)
(1) Temporary total disability may be
terminated by a self-insured employer or the bureau of workers' compensation in
the event of any of the following:
(a) The
employee returns to work.
(b) The
employee's treating physician finds that the employee is capable of returning
to his former position of employment or other available suitable
employment.
(c) The employee's
treating physician finds the employee has reached maximum medical
improvement.
(2) Except
as provided in paragraph (B)(1) of this rule, temporary total disability
compensation may be terminated after a hearing as follows:
(a) Upon the finding of a district hearing
officer, staff hearing officer, deputy or the
industrial commission that either the conditions in paragraph (B)(1)(a)
or (B)(1)(b) of this rule has occurred.
(b) Upon the finding of a district hearing
officer, staff hearing officer, deputy or the
industrial commission that the employee is capable of returning to
his/her former position of employment.
(c) Upon the finding of a district hearing
officer, staff hearing officer, deputy or the
industrial commission that the employee has reached maximum medical
improvement.
(d) Upon the finding
of a district hearing officer, staff hearing officer,
deputy or the industrial commission that the employee has received a
written job offer of suitable employment.
If a district hearing officer, staff
hearing officer, deputy or the industrial commission determines, based
upon the evidence, that as of the date of the hearing, the injured worker is no
longer justified in remaining on temporary total disability compensation, he
shall declare that no further payments may be made. If the district hearing
officer, staff hearing officer, deputy or the
industrial commission determines that the injured worker was not
justified in receiving temporary total disability compensation prior to the
date of the hearing, he shall declare an overpayment from the date the injured
worker was no longer justified in remaining on temporary total disability
compensation. Such payment shall be recovered from future awards related to the
claim or any other claim. The recovery order shall provide a method for the
repayment of any such overpayment as is reasonable, taking into account such
factors as the amount of money to be recouped, the length of the periodic
payments to be made under any future award, and the financial hardship that
would be imposed upon the employee by any specific schedule of
repayment.
