Calculating Partial Benefits

Problems and Solutions

Problem 1:

Alice was injured 1/3/13. Her AWW is $696. Her employer’s payroll week runs from Sunday through Saturday.

She was unable to work as of 1/4/13 and you paid her TTD until you learned that she returned to light-duty work on 1/24/13 (Thursday).

A. She earned $450 for the week ending 1/26/13. How much will you pay her for that week?

Problem 1 (Alice)AWW $696/Comp Rate $464

TTD 1/20 through 1/23/13 = 4 days @ $464.00 = $265.14

TPD W/E 1/26/13:

$450 (Earnings)/$300.00 (Comp Rate)

Compare Comp Rates to determine “TPD due”:

$464.00 - $300.00 = $164.00

Calculate offset for TTD benefits already paid (for 1/20 – 1/23/13):

4 days @ $464.00 = $265.14

Apply offset to “TPD due”:

$164.00 - $265.14 = $000.00

________Benefits Due W/E 1/26/13: $265.14

Problem 2: (Carol)

Carol was injured 1/11/13. Her AWW is $1230. Her employer’s payroll week runs from Monday to Sunday.

She was unable to work as of 1/12/13 and you paid her the maximum rate ($717.09) until she returned to light-duty work on 2/22/13.

A. She earned $150 for the week ending 2/24/13. How much will you pay her for that week?

Problem 2 (continued)AWW $1230/Comp Rate $820Max effective 1/1/13 = $717.09 (100% SAWW)

TPD W/E 2/24/13:$150.00 (Earnings)/$100.00 (Comp Rate)

Compare Comp Rates to determine “TPD due”:$820.00- $100.00 = $720.00 (cap @ $717.09)

TPD Due = $717.09

B. She earned $900 for the week ending 3/3/13. How much will you pay her for that week?

TPD W/E 3/3/13:$900.00 (Earnings)/$600.00 (Comp Rate)

Compare Comp Rates to determine “TPD due”:$820.00- $600.00 = $220.00TPD Due = $220.00

Problem 3 (Bill)Bill was injured 1/11/13. His AWW is $756. The weekly value

of his fringe benefits, as of 1/12/13, was $270. His employer

stopped paying his fringe benefits, effective 3/16/13. (The

SAWW effective 7/1/12 is $717.09.) His employer’s payroll

week runs from Saturday through Friday. He was unable to

work as of 1/12/13 and you paid him TTD until he returned to

light-duty work on 4/8/13 (Monday).

A. What is the Weekly Compensation Rate without fringe benefits?

$504.00 (2/3 of $756)

B. What is the Weekly Compensation Rate with fringe benefits?

$684.00 (2/3 of $1026.00)

C. If fringe benefits are included in Bill’s AWW, his weekly benefit

cannot exceed what amount?

$478.06 (2/3 of $717.09)

Problem 3 (Bill)D. He earned $30 for the week ending 4/12/13. How much will you pay him for that week?

TTD 4/6/13 through 4/7/13 = 2 days @ $504.00 = $144.00

TPD W/E 4/12/13: $30.00 (Earnings)/$20.00 (Comp Rate)Compare Comp Rates to determine “TPD due” (choose greater): $504.00 - $20.00 = $484.00

$684.00 - $20.00 = $664.00 (cap @ $478.06)

Calculate offset for TTD benefits already paid (for 4/6/13 - 4/7/13): 2 days @ $548.63= $144.00

Apply offset to “TPD due”: $484.00 – 144.00 = $340.00

Benefits Due W/E 4/12/13 $484.00

Problem 3 (Bill)E. He earned $240 for the week ending 4/19/13. How much will you pay him for that week?

TPD W/E 4/19/13:

$240.00 (Earnings)/$160.00 (Comp Rate)

Compare Comp Rates to determine “TPD due” (choose greater):

$504.00 - $160.00 = $344.00

$684.00 - $160.00 = $524.00 (cap @ $478.06)

__________

Benefits Due W/E 4/19/13 $478.06

Problem 4Don was injured 1/4/13. His AWW is $1500. His employer’s payroll week runs from Monday to Sunday.

He was unable to work as of 1/7/13 and you paid him the maximum rate ($717.09) until you learned that he began receiving weekly Unemployment benefits in the amount of $150 on 1/25/13.

A. How much will you pay him for the week ending 1/27/13?

$717.09 (“TTD due”) - $150.00 (Unemployment benefit) = $567.09 (weekly benefit after

Unemployment offset)

Problem 5 Ellen was injured 1/10/13. Her AWW is $780. Her

employer’s payroll week runs from Sunday to Saturday.

She has been unable to work since 1/11/13 and you have been paying her benefits weekly on Wednesdays. (Each payment covered the most recent Thursday through Wednesday period.)

Today is Friday, and you just learned that Ellen returned to light-duty work on Monday 1/21 (four days ago), with earnings for the partial week of $210.00.

A. How will you transition your payments from “total” to “partial”?

Problem 5 (Ellen)

Your next Wednesday payment should cover partial benefits for the week ending tomorrow (Saturday), and your calculations for that payment should be based on her earnings for the payroll week that ends tomorrow (Saturday).

Don’t forget to take an offset for the “total” benefits that you already paid (for Sunday through Wednesday).

Problem 5 (Ellen) (example)AWW $780/Comp Rate $520.00

TPD W/E Saturday 1/26/13 (tomorrow):

$210 (Earnings)/$140.00 (Comp Rate)

Compare Comp Rates to determine “TPD due”:

$520.00 - $140.00 = $380.00

Calculate offset for TTD benefits already paid (for Sunday through Wednesday):

4 days @ $520.00 = $297.14

Apply offset to “TPD due”:

$380.00 - $297.14 = $82.86

Pay $82.86 next Wednesday. All future Wednesday payments will now be in synch with the employer’s payroll (Sunday to Saturday).