JULY 1, 2023 CHANGES TO TPD CALCULATION, DEPENDENT BENEFIT INCREASE AND EXPANSION, AND EXPANSION OF PREAUTHORIZATION

On June 22, Dirk Anderson, Esq., Director of Workers’ Compensation and Safety for the Vermont Department of Labor, issued a memo regarding the recent legislative changes made to Vermont Workers' Compensation law that were passed by the Vermont General Assembly on June 20 over the Governor’s veto. These changes will go into effect on July 1, 2023. 

 The original memo that was sent out on June 22 had errors and was reissued by the Department on June 28, 2023. 

 Up until July 1^st, the method for calculating temporary partial disability (TPD) is:

 The difference between the Claimant’s pre-injury average weekly wage (AWW) and the Claimant’s current weekly wage – gross wages, not net (CWW) while disabled multiplied by 0.667. Mathematically, that is expressed like this:

 

(AWW – CWW) * 0.667

 

The new legislation keeps this method for calculating TPD but also adds a new way. The new way is:

 

The Claimant’s weekly temporary total disability rate (TTD) minus the Claimant’s current weekly wage (again, gross wages). That looks like this:

 

TTD – CWW

 

The new legislation requires that an adjuster perform BOTH calculations – both the old and the new – and then choose the larger TPD payment.

 

For example:

 

Example: Claimant has an AWW of $600. His TTD rate is therefore $540 (in this case, the Claimant’s TTD rate would be his AWW * 0.9). The Claimant has been released for light duty and now earns $300/week. Here are the two ways one must calculate the Claimant’s potential TPD:

 

Old method:

 

(AWW – CWW) * 0.667

 

So:      

($600 - $300) * 0.667 = $200.10

 

Because $600 - $300 = $300 and $300 * 0.667 is $200.10, the Claimant’s TPD payment under the old method would be $200.10

 

New method:

 

TTD – CWW

 

So:

$540 - $300 = $240

 

In this case, because the Claimant’s TPD under the new method is higher than his TPD under the old method, the Claimant’s TPD payments would be $240/week.

 

Remember that we must now calculate using both methods and choose the higher outcome, because the General Assembly wants to encourage people to return to work rather than remain on TTD.

The rest of the memo from the Director accurately discusses the increase in a Claimant’s dependent benefit, from $10 to $20 per week, and the expansion of the dependent benefit to injured workers receiving TPD. It also discusses the expansion of the pre-authorization process to include services, supplies, and medical equipment and new limitations on work search requirements. All of these changes go into effect on July 1, 2023.

 

One final note: there were previously errors in the Form 28 on the Vermont Department of Labor’s website because the form did not reflect these legislative changes. These appear to have been corrected. Please follow this link for a current Form 28, and please be aware that the increase in TTD this year is 6%, or 0.060, which is the second-highest increase in Vermont state history (after the 2021 increase of 9.8%).  Microsoft Word - Form28FY24 (vermont.gov)

 

If you have any questions regarding the new legislative requirements and calculations, we encourage you to contact us.

New Mileage Rate and Revisions to Forms 32 and P1

 On Friday, January 6^th, the Vermont Department of Labor announced several changes of note. First, the annual mileage reimbursement rate increase, which took effect on 1/1/23. The new rate is $0.655/mile, an increase of $.03/mile and the highest in Vermont’s history, though a smaller increase than last year. The historical rates and meal reimbursement information can be found on the DOL’s website at:  Mileage and Meal Reimbursement - 1-6-2023 | Department of Labor (vermont.gov)

Next, the Department of Labor announced new versions of two forms commonly used in Workers’ Compensation cases. The first in the Form 32, used for agreements for temporary compensation. Notably, the following language has been added to the bottom of the new Form 32: “By signing this agreement the employee is stating that he or she is not working, and that he or she is obligated to report promptly any work, earnings, wages or benefits to the insurance carrier/employer and the department.”

The other form updated by the Department of Labor is the Form P1, a form often used (but not required) when an employee is requesting pre-authorization of medical treatment. The new form requires for the first time that the employee attach verification of how the Form P1 was transmitted to the insurer. Further, in the event that the insurer exercises its rights under Vermont Workers' Compensation Rule 7 and obtains a medical records review, it must now specify the doctor who will conduct the records review on the  updated Form P1.