Supplemental Income Benefits (SIBs) In Texas Workers’ Compensation

If you have significant permanent impairment (an Impairment Rating of 15% or higher) then you become eligible to participate in a program that operates much like unemployment insurance if you’ve lost your job. Simply put, Supplemental Income Benefits will reimburse you for a portion of your lost wages as long as you’re making a good faith effort to find a job.

Supplement Income Benefits (SIBs) 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% or more;
• you have not returned to work because of your impairment, or you have returned to work but are earning less than 80% of the average weekly wage because of the impairment;
• you have made a good faith effort to find a job that matches your abilities to work; and
• you did not take your impairment income benefits in a lump sum payment.

Amount of Supplemental Income Benefits

This can be a little confusing. Supplemental Income Benefits equal 80% of the difference between 80% 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% of $500 (.80 x $500) = $400
Minus your wage now – 0
Equals $400

80% of $400 (.80 x S400) = $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 equals $1,391.43).

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

Example:

Your average weekly wage = $500
80% of $500 (.80 x 500) = 400
Minus your wages earned = $200

80% 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. The Division will automatically notify you if your impairment rating is 15% 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 the Division. The information to support your entitlement to the first quarter of SIBs is based on your job search efforts (if able) and wages earned during the 13 weeks before the end of your IIBs period. This 13-week period is called the qualifying period.

The Division will make a determination of entitlement based on the information on your application. The Division will review your job search efforts during the qualifying period, any possible job offers, current medical documentation provided by your doctor 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 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 other 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. Each time you file an application with the 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, or a private provider of vocational rehabilitation.

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