Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 129 - INCOME BENEFITS-TEMPORARY INCOME BENEFITS
Section 129.2 - Entitlement to Temporary Income Benefits
Universal Citation: 28 TX Admin Code ยง 129.2
Current through Reg. 49, No. 38; September 20, 2024
(a) Once temporary income benefits (TIBs) accrue, an injured employee (employee) is entitled to TIBs to compensate the employee for lost wages due to the compensable injury during a period in which the employee has disability and has not reached maximum medical improvement.
(b) Lost wages are the difference between the employee's gross average weekly wage (AWW) and the employee's gross Post-Injury Earnings (PIE). If the employee's PIE equals or exceeds the employee's AWW, the employee has no lost wages.
(c) PIE shall include, but not be limited to, the documented weekly amount of:
(1) all pecuniary wages paid to the employee
after the date of injury including wages based on work performed while on
modified duty and pecuniary fringe benefits which are paid to the employee
whether the employee has returned to work or not;
(2) any employee contribution to benefits
such as health insurance that the employee normally pays but that the employer
agrees to pay for the employee in order to continue the benefits (which does
not include the portion of the benefits that the employer normally pays
for);
(3) the weekly amount of any
wages offered as part of a bona fide job offer which is not accepted by the
employee which the insurance carrier (carrier) is permitted to deem to be PIE
under §
129.6
of this title (relating to Bona Fide Offers of Employment);
(4) the value of any full days of accrued
sick leave or accrued annual leave that the employee has voluntarily elected to
use after the date of injury;
(5)
the value of any partial days of accrued sick leave or accrued annual leave
that the employee has voluntarily elected to use after the date of injury that,
when combined with the employee's TIBs, exceeds the AWW; and
(6) any monies paid to the employee by the
employer as salary continuation based on:
(A)
a contractual obligation between the employer and the employee including
through a collective bargaining agreement;
(B) an employer policy; or
(C) a written agreement with the
employee.
(d) PIE shall not include:
(1) any non-pecuniary
wages paid to the employee by the employer after the injury;
(2) any accrued sick leave or accrued annual
leave that the employee did not voluntarily elect to use;
(3) any wages paid by the employer as salary
supplementation as provided by Texas Labor Code, §
408.003(a)(2);
(4) any moneys paid by the employer which
would otherwise be considered PIE under subsection (c) of this section but
which the employer attempts or intends to seek reimbursement from the employee
or carrier; or
(5) any money paid
to an employee under an indemnity disability program paid for by the employee
separate from workers' compensation.
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