1. (a) General. An injured employee shall not be entitled to supplemental income benefits until the expiration of the impairment income benefit period.

2. (b) Eligibility Criteria. An injured employee who has an impairment rating of 15% or greater, and who has not commuted any impairment income benefits, is eligible to receive supplemental income benefits if, during the qualifying period, the employee:

   1. (1) has earned less than 80% of the employee's average weekly wage as a direct result of the impairment from the compensable injury; and
   2. (2) has made a good faith effort to obtain employment commensurate with the employee's ability to work.
3. (c) Direct Result. An injured employee has earned less than 80% of the employee's average weekly wage as a direct result of the impairment from the compensable injury if the impairment from the compensable injury is a cause of the reduced earnings.

4. (d) Good Faith Effort. An injured employee has made a good faith effort to obtain employment commensurate with the employee's ability to work if the employee:

   1. (1) has returned to work in a position which is relatively equal to the injured employee's ability to work;
   2. (2) has been enrolled in, and satisfactorily participated in, a full time vocational rehabilitation program sponsored by the Texas Rehabilitation Commission during the qualifying period;
   3. (3) has been unable to perform any type of work in any capacity, has provided a narrative report from a doctor which specifically explains how the injury causes a total inability to work, and no other records show that the injured employee is able to return to work; or
   4. (4) has provided sufficient documentation as described in subsection (e) of this section to show that he or she has made a good faith effort to obtain employment.

5. (e) Job Search Efforts and Evaluation of Good Faith Effort. Except as provided in subsections (d)(1), (2), and (3) of this section, an injured employee who has not returned to work and is able to return to work in any capacity shall look for employment commensurate with his or her ability to work every week of the qualifying period and document his or her job search efforts. In determining whether or not the injured employee has made a good faith effort to obtain employment under subsection (d)(4) of this section, the reviewing authority shall consider the information from the injured employee, which may include, but is not limited to information regarding:

   1. (1) number of jobs applied for throughout the qualifying period;
   2. (2) type of jobs sought by the injured employee;
   3. (3) applications or resumes which document the job search efforts;
   4. (4) cooperation with the Texas Rehabilitation Commission;
   5. (5) education and work experience of the injured employee;
   6. (6) amount of time spent in attempting to find employment;
   7. (7) any job search plan by the injured employee;
   8. (8) potential barriers to successful employment searches;
   9. (9) registration with the Texas Workforce Commission; or
   10. (10) any other relevant factor.

6. (f) Calculation of amount. Subject to any approved reduction for the effects of contribution, the monthly supplemental income benefit payment is calculated quarterly as follows:

   1. (1) multiply the injured employee's average weekly wage by 80% (.80);
   2. (2) add the injured employee's wages for all 13 weeks of the qualifying period;
   3. (3) divide the total wages by 13;
   4. (4) subtract this figure from the result of paragraph (1) of this subsection;
   5. (5) multiply the difference by 80% (.80);
   6. (6) if the resulting amount is greater than the maximum rate under the Act, Texas Labor Code, §408.061, use the maximum rate; and,
   7. (7) multiply the result by 4.34821.
7. (g) Maximum Medical Improvement and Impairment Rating Disputes. If there is no pending dispute regarding the date of maximum medical improvement or the impairment rating prior to the expiration of the first quarter, the date of maximum medical improvement and the impairment rating shall be final and binding.
8. (h) Carrier-Sponsored Vocational Case Managers. The insurance carrier may provide a case manager to perform vocational assistance provided that the individual is a registered private provider and is credentialed as a Licensed Professional Counselor (LPC), Certified Case manager (CCM), Certified Rehabilitation Counselor (CRC), Certified Vocational Evaluator (CVE), or Certified Disability Management Specialist (CDMS). Specific services may be performed by other persons provided that they have the appropriate background and the work is done by or at the direction of a person with the credentials outlined in this subsection.

Source Note:The provisions of this §130.102 adopted to be effective January 31, 1999, 24 TexReg 399.