TIBs are paid as compensation to the IW for lost wages due to the compensable injury during a period in which an IW has disability and has not reached MMI. Section 129.2(a). Lost wages are the difference between the IW's gross AWW and the IW's gross post-injury earnings (PIE). If the IW's PIE equals or exceeds the IW's AWW, the IW has no lost wages. Section 129.2(b).
Section 129.2(c) provides that PIE shall include, but not be limited to, the documented weekly amount of:
1. All pecuniary wages paid to the IW after the DOI including wages based on work performed while on modified duty and pecuniary fringe benefits which are paid to the IW whether the IW has returned to work or not;
2. Any IW contribution to benefits such as health insurance that the IW normally pays but that the employer agrees to pay for the IW in order to continue the benefits (which does not include the portion of the benefits that the employer normally pays);
3. the weekly amount of any wages offered as part of a BFOE which is not accepted by the IW which the IC is permitted to deem to be PIE under Section 129.6;
4. The value of any full days of accrued sick leave or accrued annual leave that the IW has voluntarily elected to use after the DOI;
5. The value of any partial days of accrued sick leave or accrued annual leave that the IW has voluntarily elected to use after the DOI that, when combined with the IW's TIBs, exceeds the AWW; and
6. Any monies paid to the IW by the employer as salary continuation based on:
A. a contractual obligation between the employer and the IW including through a collective bargaining agreement;
B. an employer policy; or
C. a written agreement with the IW.
Section 129.2(d) provides that PIE shall not include:
1. Any non-pecuniary wages paid to the IW by the employer after the injury;
2. Any accrued sick leave or accrued annual leave that the IW did not voluntarily elect to use;
3. Any wages paid by the employer as salary supplementation as provided for by Section 408.003(a)(2);
4. Any monies paid by the employer which would otherwise be considered PIE under subsection (c) but which the employer attempts or intends to seek reimbursement from the IW or IC; or
5. Any money paid to an IW under an indemnity disability program paid for by the IW separate from workers' compensation.
Income from self-employment is PIE. The IW's compensable injury prevented her from returning to work with her employer. The IW and her husband opened a rental store. The IW occasionally actively participated in the business. The IW's income for any day or week was unknown, and the HO determined that the income was not PIE. The AP reversed and held that income from self-employment is PIE. On remand the HO was directed to determine what the IW's income was. APD 012074-s.
Long Term Disability (LTD).
If the IW pays any portion of the premiums on a LTD plan, the LTD plan is considered to paid for by the IW and the IC is not entitled to a credit. APD 030011-s.
Unemployment benefits are not considered PIE. APD 042364-s.