1. (a) Initial entitlement criteria. An injured employee who received an impairment rating of 15% or greater, and who has not commuted any impairment income benefits, is entitled to receive supplemental income benefits upon termination of the impairment income benefits period if the employee:

   1. (1) has been unemployed, or underemployed as defined in §130.101 of this title (relating to Definitions), as a direct result of the impairment from the compensable injury; and
   2. (2) has made good faith efforts to obtain employment commensurate with the employee's ability to work.
2. (b) Review of employment status. As provided by §130.10 of this title (relating to Review of Employment Status during the Impairment Income Benefits Period), not later than 10 days before the last day of the impairment income benefit period, the commission shall review the employment status of each injured employee who received an impairment rating of 15% or greater, and who has not commuted any impairment income benefits.

3. (c) Notice of determination. Not later than the last day of the impairment income benefit period, the commission shall:

   1. (1) determine entitlement or non-entitlement to supplemental income benefits; and
   2. (2) send written notice of this determination to the injured employee and the carrier by first class mail or personal delivery.

4. (d) Determination of entitlement. If the commission determines that the employee is entitled to supplemental income benefits, the notice shall:

   1. (1) state the beginning and end dates of the first compensable quarter;
   2. (2) specify the amount of the monthly payment;
   3. (3) specify the wages used to calculate the monthly payment;
   4. (4) advise the parties of the procedures for contesting the commission's determination and calculation of amount, as provided by §130.108 of this title (relating to Contesting Entitlement or Amount of Supplemental Income Benefits); and
   5. (5) enclose instructions for filing the Statement of Employment Status, a filing schedule, and a description of the consequences of late filing and failing to file.

5. (e) Referral to the Texas Rehabilitation Commission. If the commission determines that the employee may be materially assisted by vocational rehabilitation or training, the notice described in subsection (d) of this section shall additionally contain:

   1. (1) a referral to the Texas Rehabilitation Commission for appropriate services; and
   2. (2) a warning to the employee that refusing such services, or refusing to cooperate with such services, will result in loss of entitlement to supplemental income benefits.

6. (f) Determination of non-entitlement. If the commission determines that the employee is not entitled to supplemental income benefits, the notice shall:

   1. (1) state the grounds for this determination;
   2. (2) advise the parties of the procedures for contesting the commission's determination, as provided by §130.108 of this title (relating to Contesting Entitlement or Amount of Supplemental Income Benefits); and
   3. (3) enclose a Statement of Employment Status and filing instructions for claiming delayed entitlement to supplemental income benefits, as provided by §130.105 of this title (relating to Reinstated or Delayed Entitlement to Supplemental Income Benefits).

Source Note:The provisions of this §130.103 adopted to be effective April 17, 1992, 17 TexReg 2400.