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You are here: Home . wc . news . advisories . ad97-07

Advisory 97-07

NOTIFICATION OF NEW STATEMENT OF EMPLOYMENT STATUS
(EMPLOYEE'S APPLICATION FOR SUPPLEMENTAL INCOME BENEFITS)

Effective October 30, 1997, the Commission has adopted a new version of the TWCC-52, "Statement of Employment Status (Employee's Application for Supplemental Income Benefits)." An injured employee must file the TWCC-52 or TWCC-52S with the Commission for initial determination of entitlement or nonentitlement for the first quarter of benefits and with the insurance carrier for subsequent quarters.

The new form may be used immediately, but the old form will continue to be accepted and must be processed by the Commission and insurance carriers until January 1, 1998. With the third payment made for any supplemental income benefits quarter ending on any date in December 1997, carriers must provide the new Form TWCC-52 to the injured employees.

The new form, available in English and Spanish, represents a significant revision in the manner in which the information is reported by the injured employee. In addition to including space to identify the specific quarter for which the application is submitted, the new form also incorporates detailed instructions throughout the entire document to help the injured employee properly complete the required information. Further, the available space to report job searches has been increased to address the complaint from both injured employees and insurance carriers that the previous form did not contain enough spaces to properly document the injured employee's efforts during the filing period. Lastly, a calculation worksheet has been added to the last page for the reviewing authority to determine the proper amount of benefits and to explain to the injured employee why a particular amount is being paid during that specific quarter.

These revisions will ensure that the required information is provided in a format that can be properly completed by the injured employee and easily processed by the reviewing authority. These changes will also expedite the determination process and may resolve questions that previously required administrative proceedings.

Signed this 30th day of October, 1997

Robert M. Marquette, Acting Executive Director

Attachment:

TWCC-52, "Statement of Employment Status (Employee's Application for Supplemental Income Benefits)"

Distribution:

Austin Carrier Representatives, TWCC Staff, Public Information List



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