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TITLE 28INSURANCE
PART 2TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
CHAPTER 53CARRIER'S REPORT OF INITIATION AND SUSPENSION OF COMPENSATION PAYMENTS
RULE §53.63Suspension of Weekly Compensation

(a) A carrier may not suspend payment of weekly or other periodic benefits pending final adjudication until there exists evidence justifying suspension. However, in no event, unless directed otherwise by the board, shall a carrier suspend benefits until:

  (1) the injured employee returns to work;

  (2) the injured employee is released by a physician to return to work without restrictions;

  (3) the employee refused employment offered him or her consistent with any restrictions;

  (4) the statutory maximum benefit has been paid;

  (5) the claim is resolved by settlement, A-2 lump sum payment, or matured award;

  (6) evidence exists showing that the carrier has no liability for the employee's injury; or

  (7) there is a third-party settlement which relieves the carrier of its liability.

(b) Medical evidence indicating that a worker can perform work with restrictions or evidence existing showing that the injured employee has engaged in activities inconsistent with his or her impairment shall constitute good cause under §61.25 of this title (relating to Setting at Carrier's Request).

(c) Nothing in this section shall conflict with the provisions of Texas Civil Statutes, Article 8307, §4(b).


Source Note: The provisions of this §53.63 adopted to be effective July 28, 1988, 13 TexReg 3512.

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