28 Tex. Admin. Code § 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.
Notes
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