How Texas workers' compensation Supplemental Income Benefits work.

Under Texas Workers' Compensation law, there are several types of Income Benefits that can be awarded to an employee who was injured in a workplace accident. In the beginning, an injured employee will receive Temporary Income Benefits for a specified period of time. Unfortunately, some accidents may injury an employee to the point that additional Income Benefits may be needed.

The whole idea behind Supplemental Income benefits is that, after a worker is injured an released from treatment, they may not be able to earn what they used to due to their disability. So Supplementary Income Benefits pay a portion of the difference between what they used to earn before they got hurt and what they make now that they are disabled.

In this article, we'll explain how these benefits work and what work accident victims must do to qualify for them.

Questions answered on this page:

• If I am injured in a workplace accident, can I get Supplemental Income Benefits?
• What does the law say about Supplemental Income Benefits?
• When can I receive Supplemental Income Benefits?
• How can a lawyer help after a workplace accident?

Steps before Supplemental Income Benefits go into effect.

Before explaining what Supplemental Income Benefits are, it is important to understand the process that occurs prior to an employee becoming eligible to receive Supplemental Benefits:

• You had a good job, you made sufficient money, but you were injured on the job.
• After filing for workers' compensation, you began receiving Temporary Income Benefits.
• After the accident, there will come a time when you reach Maximum Medical Improvement, or MMI, and you are given an impairment rating and started receiving Impairment Income Benefits.
• Once these benefits expire, hopefully you have sought out a new job or returned to your old workplace with a light duty job.
• However, if you've gone back to work and are earning less than what you did prior to the accident, there is an opportunity for you to seek Supplemental Income Benefits.

How do you receive Supplemental Income Benefits?

According to the Texas Labor Code section 408.142, an employee must meet four requirements in order to receive Supplemental Income Benefits after the Impairment Income Benefits have expired. Below we review the law that specifies the requirements.

Sec. 408.142. SUPPLEMENTAL INCOME BENEFITS.

• (a) An employee is entitled to Supplemental Income Benefits if, on the expiration of the Impairment Income Benefit period computed under Section 408.121, the employee:
  • (1) has an impairment rating of 15 percent or more as determined by this subtitle from the compensable injury;
  • (2) has not returned to work or has returned to work earning less than 80 percent of the employee's average weekly wage as a direct result of the employee's impairment;

   

As an example, consider a worker who was severely injured but was able to go back to work. Prior to the accident he made $300/week, but after the accident his injury only enables him to work a job where he makes $200/week. In this case, he would satisfy the second requirement because $200 is less than 80% of $300.

Sec. 408.142. SUPPLEMENTAL INCOME BENEFITS.

• (a) An employee is entitled to Supplemental Income Benefits if, on the expiration of the impairment income benefit period computed under Section 408.121, the employee:
  • (3) has not elected to commute a portion of the impairment income benefit under Section 408.128; and
  • (4) has complied with the requirements adopted under Section 408.1415 [The Work Search Compliance Standards]

   

The third requirement is that the employee has not taken his impairment income benefits as a lump sum, or at all once. The fourth and final requirement is the employee has met all work search compliance standards. This means the employee participated in various rehabilitative therapies, job searches, and documented all efforts.

Supplemental Income Benefits Formula

With Supplemental Income Benefits, the injured employee is paid 80% of the difference between 80% of his or her Average Weekly Wage and what he or she is earning now.

Supplemental Income Benefits Formula

4.34821(.8[ (.8 x Average Weekly Wage) - current weekly wages]) = $ the amount you receive in monthly payments.

Below are two examples that help explain the formula a little better.

• Example 1: If your Average Weekly Wage is $500 and you found a new job paying $100 a week, your Supplemental Income Benefits pay would be calculated by multiplying .8($500) - $100, which equals $300, and then multiplying that by .8 which equals $240, your weekly pay amount. Since Supplemental Income Benefits are paid monthly, you would then multiply this amount by 4.34821, the average number of months in a year, for a total of $1,043.57, your monthly pay for Supplemental Income Benefits.
• Example 2: If your Average Weekly Wage is $400 and you cannot find a new job because of your injury, you Supplemental Income Benefits pay would be calculated by multiplying .8($400) - $0, which equals $320, and then multiplying that by .8, which equals $256, your weekly pay amount. Since Supplemental Income Benefits are paid monthly, you would then multiply this amount by 4.34821, the average number of months in a year, for a total of $1,113.14, your monthly pay for Supplemental Income Benefits.

Supplemental Income Benefits Time Frames

There is also a way that an employee might be able to receive Supplemental Income Benefits even if he does not meet the second requirement (earning 80% or less of previous pay) immediately after his injury. The law explains that if, at anytime within 90 days of the expiration of the employee's Impairment Income Benefit period, he satisfies the second requirement, then he may be able to obtain Supplemental Income Benefits.

A hypothetical situation that would illustrate this provision would be if a worker is injured, returns to work, but is later demoted or forced to take a different job due the effect of his injury. If his earning capacity is less than 80% of his original salary, then he would qualify for Supplemental Income Benefits, provided that the change occurred within the 90 days.

Our Work Accident Attorneys at Grossman Law Offices Know the Law

Because of both the complexities involved in proving Supplemental Income Benefits owed and the fact that insurance companies will argue that you do not deserve them, you need an experienced work injury attorney to fight for your rights under the law.

Our attorneys at Grossman Law Offices have over 25 years of experience and know how to deal with the insurance companies and get you the compensation that you deserve. Call today for a free consultation at (855) 326-0000.

Related Articles for Further Reading:

• How Is Workers' Compensation Law Different from Non-Subscriber Work Injury Law?
• Does Workers' Compensation Cover Pain Medication and Prescription Drugs?
• When Can Parents File a Claim for Workers' Compensation Death Benefits?