Revision 09-4; Effective December 1, 2009
Workers' compensation benefits are unearned income. A portion of a person's workers' compensation may be designated for medical, legal or related expenses. Request the person to provide verification of payment and, in addition, any expense required to obtain the benefit.
A person who suffers a work-related injury or illness may be eligible for workers' compensation benefits. These benefits are administered by the Industrial Accident Board under the Texas Workers' Compensation Act. If a person dies as a result of a work-related injury or illness, his dependents or beneficiaries may be eligible for workers' compensation benefits.
Determine the monthly amount of workers' compensation benefits by multiplying the weekly benefit by 4.33. (These benefits are usually paid on a weekly basis.) Also determine the expected duration of the workers' compensation benefits.
Determine and exclude the portion, if any, of the workers' compensation that is considered an expense required to obtain the benefit.
Reference: See Section D-7400, Use of Third-Party Resources, for policies governing recovery of Medicaid payments when additional workers' compensation is received for medical expenses incurred after Medicaid eligibility began.
Verify workers' compensation benefits by one or more of the following methods:
- Viewing or obtaining a copy of the person's notice of workers' compensation benefits.
- Obtaining a letter from an official of the Industrial Accident Board.
- Viewing or obtaining copies of the person's weekly checks (least desirable method).
- Obtaining proof of any medical, legal or other related expenses if that information is not included in information already provided.
- Documenting a contact with a knowledgeable source.