The following words and terms, when used in this chapter, shall
have the following meanings, unless the context clearly indicates
otherwise.
(1) Application for Supplemental Income Benefits--The
Division form required pursuant to Labor Code §408.143(b) containing
the following information:
(A) a statement, with supporting payroll documentation,
that the employee has earned less than 80% of the employee's average
weekly wage as a direct result of the impairment from the compensable
injury;
(B) the amount of the employee's wages during the qualifying
period;
(C) a statement, with supporting documentation, that
the employee has complied with Labor Code §408.1415 and this
subchapter; and
(D) for self-employed individuals, copies of all supporting
documentation to establish the amount of self-employment income earned
during the qualifying period and any other pertinent documentation
of efforts to establish or maintain a self-employed enterprise during
the qualifying period.
(2) First Quarter--The 13 weeks beginning on the day
after the last day of the impairment income benefits period.
(3) Impairment income benefits period--The number of
weeks computed under Labor Code §408.121 for which the injured
employee is entitled to receive impairment income benefits, starting
with the day after the date the employee reached maximum medical improvement.
(4) Qualifying period--A period of time for which the
employee's activities and wages are reviewed to determine eligibility
for supplemental income benefits. The qualifying period ends on the
14th day before the beginning date of the quarter and consists of
the 13 previous consecutive weeks. In accordance with §130.100(a)
of this title (relating to Applicability), a qualifying period that
begins on or after July 1, 2009, is subject to the provisions of this
subchapter, and a qualifying period that begins prior to July 1, 2009,
remains subject to the rules in effect on the date the qualifying
period begins.
(5) Reviewing authority--The person who reviews the
Application for Supplemental Income Benefits and other information
to make the determination of entitlement or non-entitlement to supplemental
income benefits including Division staff for the first quarter determination
and the insurance adjuster for subsequent quarter determinations.
(6) Subsequent Quarter--A 13-week period beginning
on the day after the last day of a previous quarter. The term subsequent
quarter applies to all quarters after the first quarter.
(7) Vocational Rehabilitation Services--Services which
can reasonably be expected to benefit the employee in terms of employability
including, but not limited to, identification of the employee's physical
and vocational abilities, training, physical or mental restoration,
vocational assessment, transferable skills assessment, development
of and modifications to an individualized vocational rehabilitation
plan, or other services necessary to enable an injured employee to
become employed in an occupation that is reasonably consistent with
his or her strengths, physical abilities including ability to travel,
educational abilities, interest, and pre-injury income level.
(8) Vocational rehabilitation program--Any program,
provided by the Texas Workforce Commission (TWC), a comparable federally-funded
rehabilitation program in another state under the Rehabilitation Act
of 1973, as amended, or a private provider of vocational rehabilitation
services, for the provision of vocational rehabilitation services
designed to assist the injured employee to return to work that includes
a vocational rehabilitation plan. A vocational rehabilitation plan,
also known as an Individual Plan for Employment at TWC, includes,
at a minimum, an employment goal, any intermediate goals, a description
of the services to be provided or arranged, the start and end dates
of the described services, and the injured employee's responsibilities
for the successful completion of the plan.
(9) Wages--All forms of remuneration payable for personal
services rendered during the qualifying period as defined in Labor
Code §401.011(43), including the wages of a bona fide offer of
employment which was not accepted.
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| Source Note: The provisions of this §130.101 adopted to be effective January 31, 1999, 24 TexReg 399; amended to be effective November 28, 1999, 24 TexReg 10339; amended to be effective July 1, 2009, 34 TexReg 2138; amended to be effective April 15, 2018, 43 TexReg 2153 |
