PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 521 – Workers' Compensation/Public Disability Benefit (WC/PDB) OffsetSubchapter 20 – State Specific Workers' Compensation (WC) ProceduresTransmittal No. 23, 11/20/2018
This is a minor update to Nebraska WC POMS to include a reminder to check available online resources for WC payment information in DI 52140.020.
This is a Quick Action Transmittal (QAT). This revision does not change or introduce new policy or procedure.
Summary of Changes
DI 52120.150 Nebraska Workers' Compensation (WC)
Subsection F.3. - Added a thrid paragraph to remind technicians to check the WC Resource page in DI 52140.020 for states with available online resources.
The Nebraska WC Court administers WC. WC is provided through private carriers but employers may self-insure.
Nebraska WC law can be located in Chapter 48 of their Revised Statutes; section 48-121 describes indemnity payments. Nebraska does not pay disfigurement benefits. All periodic payments are subject to the state maximum and minimum amounts. The maximum amount of WC payment is based on the date of injury; the minimum WC payment has been $49 per week since 04/22/1973.
These payments are based on 2/3 of the individual’s weekly wage and are paid for the duration of the disability.
These disability benefits are:
TP: Paid when the individual is able to return to work, but under limited circumstances such as for a few hours a day or at a job which pays less than the job held at the time of the injury. TP is paid at the rate of 2/3 of the difference between the wages before and after the injury. TP is limited to 300 weeks.
PP Loss of a Member Benefits: Paid for the loss (or loss of use) of a body part such as a leg or hand based upon the statutory value of the various body parts. These benefits are paid at the rate of 2/3 of the individual's average weekly wage, times the number of weeks of compensation set out in the statutory schedule. These benefits are paid in addition to TT starting upon the termination of TT; they are NOT reduced for TT paid.
PP to the Body as a Whole: Paid for a loss of earning power because of permanent disability resulting from the injury. The WC rate is based on the percentage of disability suffered, times 2/3 of the individual's average weekly wage. These benefits are limited to a maximum of 300 weeks LESS the number of weeks of temporary and permanent disability paid.
Copies of voluntary lump sum settlements must be filed with the Nebraska WC Court and approved by them in order to be binding on the parties and terminate the individual's right to any further benefits.
These payments may be paid in a lump sum, or over a period of weeks.
If permanent disability benefits are paid over a number of weeks without a lump sum settlement, a claim for additional benefits due to increased disability may be made at any time within two years of the date of the last WC payment.
Nebraska does not give COLAs on its WC.
Nebraska law does not permit representation by anyone but an attorney or the individual himself. ‘Reasonable’ fees are allowed (generally 20 to 25 percent), and are usually paid by the injured individual.
Nebraska does not offset WC for receipt of RIB.
There is normally a 6 month time limit for filing a WC claim, or an appeal to the denial of a claim. Claims are generally barred unless the parties agree on the WC payable or one of the parties files a petition within two years after the date of injury (or within two years of the last WC payment made).
The disabled individual should always be the first source of verification.
Carrier information is attainable from Nebraska’s WC Court if the employer is known, as insurance companies are required to report to the court each WC insurance policy they issue.
SSA signed an agreement with the state agency for online access to Nebraska’s WC records. Designated SSA personnel in the Regional Offices (ROs), Program Centers (PCs), and Field offices (FOs) can obtain Nebraska WC payment verification from their workstations.
The State of Nebraska requires a “User Name” and “password” to access the NWCC
SSA Web Application. FO and PC staff must contact their Regional Administrator to request access. For Administrator access in the RO and PC, please submit your request to ||KC CPS.
Once you are certain the WC evidence is not already in file, check the WC Resource Page in DI
52140.020 since NE is a State that provides SSA with limited access to its online records. The value of online records can vary from State to State and some development may still be required. However, the sites available usually provide contact information for the employer, WC carrier or the WC attorney, which can jump-start the development process. Also included in the WC resource intranet site is a limited list of individuals in the PC with online access to those individual State records.
WC forms are only occasionally seen. Documentation is usually received as screen printouts.
This is filed with the WC Court within 10 days after the employer or carrier is given notice or has knowledge of the injury.
This is filed with the WC Court:
within 14 days following the initial payment of WC benefits;
within 14 days following the denial of a claim or a change to a previous report;
following the closing of any case for which benefits have been paid;
within 14 days following payment pursuant to a final order, award, or judgment of the court (including an order approving a lump sum settlement or settlement agreement); and
on the semi-annual anniversary of the date of injury, and every 180 days thereafter, until the case is closed.
This form is NOT used by SSA. For information regarding obtaining proof of Nebraska WC payments from the state, see subsection DI 52120.150F. in this section.
The exhibits are:
Form 1: First Report of Alleged Occupational Injury or Illness: http://www.wcc.ne.gov/publications/form1.pdf
Form 4: Subsequent Report: http://www.wcc.ne.gov/publications/form4.pdf
Minimum and Maximum WC Rates Chart: http://www.wcc.ne.gov/legal/benefits.pdf
Nebraska WC Court: http://www.wcc.ne.gov/
Nebraska WC Act (Revised Statutes Chapter 48): http://www.legislature.ne.gov/laws/browse-chapters.php?chapter=48