Supplemental Income Benefits (SIBs), supplemental income.#Supplemental #income

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Supplemental Income Benefits (SIBs)

Supplement Income Benefits (SIBs) are income benefits that you apply for quarterly (4 times per year, or every 3 months) and are paid monthly to injured employees that meet specific eligibility requirements.

You may be entitled to SIBs if you meet the following entitlement requirements:

  • you have an impairment rating of 15 percent or more;
  • you have not returned to work because of your impairment, or you have returned to work, but are earning less than 80 percent of your average weekly wage because of the impairment;
  • you have demonstrated an active effort to comply with TDI-DWC work search requirements; and
  • you did not take your impairment income benefits in a lump sum payment.

Amount of Supplemental Income Benefits

Supplemental Income Benefits equal 80 percent of the difference between 80 percent of your average weekly wage (earned prior to your work-related injury) and your weekly wages (if you have any earnings or offered wages during this 13 week period) after the work-related injury.

For example, if your average weekly wage was $500 before you were injured, and your injury caused you to lose all of your income, your SIBs rate would be $320 a week:

Your average weekly wage $500

80 percent of $500 (.80 x $500) = $400

Minus your wage now – $0

80 percent of $400 (.80 x $400) = $320

Supplemental income benefits are paid monthly. To determine the amount of your monthly SIBs, multiply the weekly benefit amount by the average number of weeks in a month (4.34821). In this example, your monthly supplemental income benefit would be $1,391.43:

$320 x 4.34821 = $1,391.43

If you earn any wages during the qualifying period, the wages are deducted when calculating your SIBs rate.

Your average weekly wage $500

80 percent of $500 (.80 x $500) = $400

Minus your wages earned $200

80 percent of $200 (.80 x $200) = $160

$160.00 x 4.34821 = $695.71 (monthly SIBs rate)

When Supplemental Benefits Begin and End

If you are eligible, Supplemental Income Benefits will begin the day after your Impairment Income Benefits end. TDI-DWC will automatically notify you if your impairment rating is 15 percent or greater and inform you of what information is necessary to support your application for the 1st quarter of SIBs. The application for the 1st quarter of SIBs is sent to TDI-DWC. The information to support your entitlement to the first quarter of SIBs is based on your job search efforts and wages earned during the 13 weeks prior to the 14 th day before the quarter begins. This 13-week period is called the qualifying period.

TDI -DWC will make a determination of entitlement based on the information on your application. TDI-DWC will review your job search efforts during the qualifying period, any possible job offers, current medical documentation supporting why you are unable to work (if applicable), and will look at whether your inability to earn your pre-injury wage is a direct result of your impairment.

The insurance carrier will provide you with an application for future quarters of SIBs with the first payment of any quarter or with any notice of non-entitlement. You must send all future SIBs applications to the insurance carrier showing that you are eligible to receive SIBs. If the insurance carrier agrees you are eligible, you will receive benefits for the quarter. If the insurance carrier determines you are not eligible to receive SIBS for the quarter, they will issue a notice of non-entitlement containing sufficient information for you to understand the reason(s) for their decision.

If an injured employee wishes to contest the determination made by TDI-DWC for the 1 st quarter or the insurance carrier for subsequent quarters, regarding non-entitlement to, or the amount of, SIBs they may request a Benefit Review Conference by contacting the local TDI-DWC Field Office.

Each time you file an application with the insurance carrier, you must show that:

  • you looked for work each week of the qualifying period; or
  • you have current medical documentation from your doctor that explains clearly why your work-related injury or illness prevented you from working or looking for work during that 13-week timeframe; and
  • your cooperation with the Texas Department of Assistive Rehabilitative Services (DARS), or a private provider of vocational rehabilitation.

Your entitlement to receive SIBs ends at 401 weeks (approximately 7 1/2 years) from the date of your injury. If you have an occupational illness, entitlement for supplemental income benefits ends at 401 weeks from the date you first became eligible to receive income benefits.

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