Legislation
SECTION 206
Non-duplication of benefits
Workers' Compensation (WKC) CHAPTER 67, ARTICLE 9
§ 206. Non-duplication of benefits. 1. No disability benefits shall be
payable under section two hundred four or two hundred seven of this
article:
(a) in a weekly benefit amount which, together with any amount that
the employee receives or is entitled to receive for the same period or
any part thereof as a permanent disability benefit or annuity under any
governmental system or program, except under a veteran's disability
program, or under any permanent disability policy or program of an
employer for whom he or she has performed services, would, if
apportioned to weekly periods, exceed his or her weekly benefit amount
under this section, provided however, that there shall be no offset
against the benefits set forth in this article if the claim for
disability benefits is based on a disability other than the permanent
disability for which the aforesaid permanent disability benefit or
annuity was granted;
(b) with respect to any week for which payments are received under the
unemployment insurance law or similar law of this state or of any other
state or of the United States;
(c) subject to the provisions of subdivision two of this section, for
any period with respect to which benefits, compensation or other
allowances (other than workers' compensation benefits for a permanent
partial disability occurring prior to the disability for which benefits
are claimed hereunder) are paid or payable under this chapter, the
volunteer firefighters' benefit law, or any other workers' compensation
act, occupational disease act or similar law, or under any employers'
liability act or similar law; under any other temporary disability or
cash sickness benefits act or similar law; under section six hundred
eighty-eight, title forty-six, United States code; under the federal
employers' liability act; or under the maritime doctrine of maintenance,
wages and cure.
2. If an employee who is eligible for disability benefits under
section two hundred three or two hundred seven of this article is
disabled and has claimed or subsequently claims workers' compensation
benefits under this chapter or benefits under the volunteer
firefighters' benefit law or the volunteer ambulance workers' benefit
law, and such claim is controverted on the ground that the employee's
disability was not caused by an accident that arose out of and in the
course of his employment or by an occupational disease, or by an injury
in line of duty as a volunteer firefighter or volunteer ambulance
worker, the employee shall be entitled in the first instance to receive
benefits under this article for his or her disability. If benefits have
been paid under this article in respect to a disability alleged to have
arisen out of and in the course of the employment or by reason of an
occupational disease, or in line of duty as a volunteer firefighter or a
volunteer ambulance worker, the employer or carrier or the chair making
such payment may, at any time before award of workers' compensation
benefits, or volunteer firefighters' benefits or volunteer ambulance
workers' benefits, is made, file with the board a claim for
reimbursement out of the proceeds of such award to the employee for the
period for which disability benefits were paid to the employee under
this article, and shall have a lien against the award for reimbursement,
notwithstanding the provisions of section thirty-three of this chapter
or section twenty-three of the volunteer firefighters' benefit law or
section twenty-three of the volunteer ambulance workers' benefit law
provided the insurance carrier liable for payment of the award receives,
before such award is made, a copy of the claim for reimbursement from
the employer, carrier or chair who paid disability benefits, or provided
the board's decision and award directs such reimbursement therefrom.
3. No family leave benefits shall be payable under section two hundred
four of this article:
(a) During periods when the employee is receiving total disability
payments pursuant to a claim for workers' compensation, volunteer
firefighters' benefits or volunteer ambulance workers' benefits, except
that when the employee is receiving payments for partial disability or
reduced earnings under such laws, the family leave benefit, when
combined with the benefits under such laws shall not exceed the average
weekly wage in the employment for which family leave benefits are
sought;
(b) To an employee who is not employed or is on administrative leave
from his or her employment;
(c) To an employee during periods where the employee is collecting
sick pay or paid time off from the employer; and
(d) for any day in which claimant works at least part of that day for
remuneration or profit for the covered employer or for any other
employer while working for remuneration or profit, for him or herself,
or another person or entity, during the same or substantially similar
working hours as those of the covered employer from which family leave
benefits are claimed, except that occasional scheduling adjustments with
respect to secondary employments shall not prevent receipt of family
leave benefits.
4. Unless otherwise expressly permitted by the employer, benefits
available under 29 U.S. Code Chapter 28 (The Family and Medical Leave
Act) must be used concurrently with family leave benefits. For a
subsequent unrelated disability, an employee may seek benefits up to the
maximum number of available weeks permitted in this article.
5. A covered employer is not required to permit more than one employee
to use the same period of family leave to care for the same family
member.
payable under section two hundred four or two hundred seven of this
article:
(a) in a weekly benefit amount which, together with any amount that
the employee receives or is entitled to receive for the same period or
any part thereof as a permanent disability benefit or annuity under any
governmental system or program, except under a veteran's disability
program, or under any permanent disability policy or program of an
employer for whom he or she has performed services, would, if
apportioned to weekly periods, exceed his or her weekly benefit amount
under this section, provided however, that there shall be no offset
against the benefits set forth in this article if the claim for
disability benefits is based on a disability other than the permanent
disability for which the aforesaid permanent disability benefit or
annuity was granted;
(b) with respect to any week for which payments are received under the
unemployment insurance law or similar law of this state or of any other
state or of the United States;
(c) subject to the provisions of subdivision two of this section, for
any period with respect to which benefits, compensation or other
allowances (other than workers' compensation benefits for a permanent
partial disability occurring prior to the disability for which benefits
are claimed hereunder) are paid or payable under this chapter, the
volunteer firefighters' benefit law, or any other workers' compensation
act, occupational disease act or similar law, or under any employers'
liability act or similar law; under any other temporary disability or
cash sickness benefits act or similar law; under section six hundred
eighty-eight, title forty-six, United States code; under the federal
employers' liability act; or under the maritime doctrine of maintenance,
wages and cure.
2. If an employee who is eligible for disability benefits under
section two hundred three or two hundred seven of this article is
disabled and has claimed or subsequently claims workers' compensation
benefits under this chapter or benefits under the volunteer
firefighters' benefit law or the volunteer ambulance workers' benefit
law, and such claim is controverted on the ground that the employee's
disability was not caused by an accident that arose out of and in the
course of his employment or by an occupational disease, or by an injury
in line of duty as a volunteer firefighter or volunteer ambulance
worker, the employee shall be entitled in the first instance to receive
benefits under this article for his or her disability. If benefits have
been paid under this article in respect to a disability alleged to have
arisen out of and in the course of the employment or by reason of an
occupational disease, or in line of duty as a volunteer firefighter or a
volunteer ambulance worker, the employer or carrier or the chair making
such payment may, at any time before award of workers' compensation
benefits, or volunteer firefighters' benefits or volunteer ambulance
workers' benefits, is made, file with the board a claim for
reimbursement out of the proceeds of such award to the employee for the
period for which disability benefits were paid to the employee under
this article, and shall have a lien against the award for reimbursement,
notwithstanding the provisions of section thirty-three of this chapter
or section twenty-three of the volunteer firefighters' benefit law or
section twenty-three of the volunteer ambulance workers' benefit law
provided the insurance carrier liable for payment of the award receives,
before such award is made, a copy of the claim for reimbursement from
the employer, carrier or chair who paid disability benefits, or provided
the board's decision and award directs such reimbursement therefrom.
3. No family leave benefits shall be payable under section two hundred
four of this article:
(a) During periods when the employee is receiving total disability
payments pursuant to a claim for workers' compensation, volunteer
firefighters' benefits or volunteer ambulance workers' benefits, except
that when the employee is receiving payments for partial disability or
reduced earnings under such laws, the family leave benefit, when
combined with the benefits under such laws shall not exceed the average
weekly wage in the employment for which family leave benefits are
sought;
(b) To an employee who is not employed or is on administrative leave
from his or her employment;
(c) To an employee during periods where the employee is collecting
sick pay or paid time off from the employer; and
(d) for any day in which claimant works at least part of that day for
remuneration or profit for the covered employer or for any other
employer while working for remuneration or profit, for him or herself,
or another person or entity, during the same or substantially similar
working hours as those of the covered employer from which family leave
benefits are claimed, except that occasional scheduling adjustments with
respect to secondary employments shall not prevent receipt of family
leave benefits.
4. Unless otherwise expressly permitted by the employer, benefits
available under 29 U.S. Code Chapter 28 (The Family and Medical Leave
Act) must be used concurrently with family leave benefits. For a
subsequent unrelated disability, an employee may seek benefits up to the
maximum number of available weeks permitted in this article.
5. A covered employer is not required to permit more than one employee
to use the same period of family leave to care for the same family
member.