Qualifying for Supplemental Income Benefits

Abilene Texas workers compensation attorney

I practice workers' compensation law in Abilene, Texas. One of the most difficult tasks that many of my clients face in connection with their claims is qualifying for Supplemental Income Benefits (or SIBS).

SIBs benefits only become available to an injured employee relatively late in the process. Before qualifying for SIBS, the injured employee must first be declared to be at Maximum Medical Improvement, a measure of whether the employee is expected to make substantial gains in his or her treatment. After that, the injured employee receives an impairment rating and receives Impairment Income Benefits for that rating for a certain period of time.

In most situations, once the Impairment Income Benefits have ended, no more income benefits are available for the claimant. However, in some situations - where the impairment rating is 15% or higher, and where the employee has not returned to work at full pay, it is possible to secure SIBs.

Even then, however, qualifying for SIBs is challenging. The so-called "work search requirements" require an employee to meticulously document three months' worth of efforts to obtain a job. The paperwork involved in doing this is so detailed, that most employees simply never pursue SIBs.

The "work search" requirements can also be fulfilled if the employee is actively participating in a qualified vocational rehabilitation program or a work search program conducted through the Texas Workforce Commission.

One final way to satisfy the "work search" requirements is through a medical narrative, which must come from a medical doctor. The narrative must specifically explain how the work injury causes a total inability to work for the entire period which the employee is attempting to document. Getting these narratives into a format that is acceptable to the insurance carrier - and to the Division of Workers' Compensation - can be its own challenge, but it is usually a lot easier than the documented work-search requirements.

The bottom line is this: unless you have a very serious, disabling injury, don't count on receiving SIBs at the end of your claim. If you are unable to get back to work at this stage, you should by all means consider qualifying for SIBs, but you should also be looking for other alternatives, such as Social Security disability.

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