HAR §12-10-27. Benefit rate adjustment for permanently and totally disabled worker

(a) Pursuant to section 386-35, HRS, insurers and self-insured employers shall make benefit rate adjustments to workers who are permanently and totally disabled. Insurers and self-insured employers shall be entitled to reimbursement from the special compensation fund for the supplemental amounts paid. (b) Claim for reimbursement shall be submitted on a form prescribed by the director. The reimbursement request shall include claimant's name, social security number, date of accident, age, case number, weekly compensation rate, and the amount of adjustment paid to the claimant. (c) The request for reimbursement shall be submitted to the department annually by January 31 of the subsequent calendar year. The request shall be audited by the 10 department and the appropriate sum paid to the insurer or self-insured employer by June 30 of the year the request was filed. Reimbursement requests received after January 31 may be paid by the department upon showing of good cause for the late filing. [Eff: 4/30/81; am 12/8/94] (Auth: HRS §386-72) (Imp: HRS §386-35) §12-10-28 Subsequent injuries which would increase disabilities under section 386-33, HRS. (a) Within sixty days after medical care is prescribed and refused, or when curative medical care and rehabilitation is exhausted, and it is not likely the employee will be further rehabilitated or restored to preinjury status, the employee shall be deemed to have reached maximum medical stabilization. The extent of medical impairment preexisting the work injury, shall be assessed by a physician pursuant to section 12-10-21(a). The director shall convene a hearing to determine the temporary total disability period, the extent of permanent disability, and the responsibilities of the employer and the special compensation fund. (b) In determining an employer's liability of one hundred four weeks of disability pursuant to section 386-33(a)(1) and (2), HRS, the employer shall receive no credit for compensation paid to an employee during periods of temporary total disability. The employer shall receive credit for all compensation paid to an employee on account of permanent partial disability resulting from the injury as against the liability of one hundred four weeks of permanent partial or permanent total disability. (c) In determining an employer's liability of one hundred four weeks of disability pursuant to section 386-33(a)(3), HRS, the employer shall receive no credit for compensation paid to an employee on account of temporary total, temporary partial, permanent partial, or permanent total disability. (d) The product of one hundred four or thirty-two multiplied by the employee's weekly benefit rate pursuant to section 386-31(a), HRS, on the date of injury shall be used to determine credit for one hundred four or thirty-two weeks for disabilities covered by section 386-32(a) HRS. (e) The product of thirty-two multiplied by the employee's weekly benefit rate pursuant to section 386-31(a), HRS, on the date of injury shall be used to determine 11 credit for thirty-two weeks for death benefits covered by sections 386-41 through 386- 43, HRS. The product of one hundred four multiplied by the dependents' weekly benefit rate pursuant to sections 386-41 and 386-43, HRS, shall be used to determine credit for one hundred four weeks for death benefits covered by sections 386-41 through 386-43, HRS. (f) In the case of part-time employment, credit for thirty-two and one hundred four weeks shall be calculated as if the employee had been a full-time employee in accordance with section 386-51, HRS. (g) In computing the offset for the amount awarded by a prior compensable injury under section 386-33(a)(1), HRS, the employer is responsible for documenting the amount awarded for the prior compensable injury. In cases involving the special compensation fund, the entire permanent partial disability award will first be offset by the amount awarded for the prior compensable injury. The employer will then be liable for one hundred four weeks and the special compensation fund will be liable for the balance. (h) The special compensation fund shall not be liable for compensation if the subsequent injury is so severe that it alone would have caused permanent total disability or death. [Eff:12/17/82; am 2/11/91; am 11/22/97] (Auth: HRS §386-72) (Imp: HRS §§386-31, 386-32, 386-33, 386-41, 386-42, 386-43, 386-51)