Workers comp certified doctor gave me a rating of 44%. Worker’s Comp. said they will give me impairment rating benefits at an impairment rating of 5% until they can verify the 44%. How can they legally do this since my impairment rating came from their certified doctor to begin with?
answered on Dec 27, 2023
The Carrier does not have to accept the rating provided by the state selected Designated Doctor. They can hire a private doctor (RME) and require you to go to this doctor. Then they can challenge the rating before and Administrative Law Judge (ADJ) in a Contested Case Hearing (Administrative Court).
workers compensation. He also has esophageal cancer that is metastatic and extremely aggressive. He days ago recieved the pt scan results that indicate the cancer has spread to more areas of his body. Our question is, being that this cancer is as aggressive as it is, is there a way to get a... View More 
answered on Dec 27, 2023
I sorry to hear you husband is having a rough go of it. If your claim is filed through the Texas Department of Insurance, Division of Workers' Compensation, there is no settlement. If surgery has not been recommended or he chooses not to have the elective surgery, you could attempt to get an... View More
They moved me to a different department I was told temporarily while being on light duty. But just two days ago one of the coaches acted as if he is switching me permanently. Which means I get to pay decrease and lose my position I had all do to be hurt. I work at Walmart is this allowed
answered on Mar 13, 2023
If your claim is in Texas, Walmart no longer carries workers' compensation through the Texas Department of Insurance, Division of Workers' compensation. They are nonsubscribers to workers' comp. Walmart has it's own private insurance. I believe your employer can permanently... View More
I work for a school district and fell on campus. Over time my injury was getting worse, even though I sought treatment that day and months after. TASB had a peer review done that agreed my injury was likely caused by a fall and that surgery was recommended. After working with my dr to remedy the... View More
answered on Jan 3, 2023
The adjuster on your file does not have medical training so whether the surgery is reasonable and necessary is subcontracted out to medical specialist that determine whether the requested procedure meets ODG guidelines. If the LHL-009 (Request for IRO) is not successful, then I would recommend you... View More
answered on Nov 2, 2022
I am not aware of any 8 hour time frame. Usually, the further out the test is taken the more likely it is that you would be intoxicated. The drugs/alcohol will leave the system with time.
I deliver lumber for a company. On Oct 20, 2023, I was delivering a load to a job site where the lift fell into a septic tank, which resulted in tearing my rotator cuff. I found out that the builder knew the septic tank was there, but only placed small flags to mark the area. Considering that... View More
answered on Jan 30, 2024
You may have established the basic facts for a claim for negligence (failure to properly warn) against the land owner and/or builder of the premises. Lawyers refer to this as a third party claim since you also have a claim for workers' compensation.
Everywhere I read, it says I have to return to work for three months in order to receive my impairment, income benefits in a lump sum, is this true if I was let go of from my employer, because of the injury
answered on Dec 27, 2023
Yes. That's true. Contact OIEC 1-866-393-6432 or an attorney of your choice to verify. You must have worked for 3 months earning 80% of pay.
They are not providing proper medical care
answered on Aug 19, 2023
My law office doesn't handle ERISA claims. If your claim does not involve negligence on behalf of the employer or other third party, it is almost impossible to obtain legal representation. For this reason, the Carrier's offer little to no support. I like to refer to it as fake... View More
A designated Dr agreed I had compensable injury. Carrier has an IR Dr. Examine me. His report was fairly neutral & recommended more testing. The IR report shows up minutes prior to final hearing! I didn’t have a chance to read it. Was this dirty pool or typical for workers comp cases in TX?
answered on May 17, 2023
If the report was not timely exchanged before the hearing, you could have objected to the admission of this exhibit. It's not dirty pool in my opinion. The lawyer probably just got the report. His duty to his client is to try to get it into the trial. It's your job to object to the... View More
I injured my right knee during a slip and fall at work. The injuries are a complete tear of the ACL, partial tear of the MCL and buckling of the PCL. I have arthritis in me knee and the only surgery that me doctor will do is a complete knee replacement. The Worker’s Comp insurance carrier said... View More
answered on Sep 15, 2022
It is very difficult to prove a total keen replacement is due to your work related injury. You will need an expert medical opinion to state all the conditions for which you need the total knee replacement are a result of the work injury within a reasonable medical probability. If you prove this,... View More
For the last 13 weeks they put down 20 hours, 33 hours, 30 hours, 40 hours etc. I was actually working a ton of overtime. 60 hours, 60 hours, 58 hours, 48 hours, etc. there was only 1 week that I worked 38 hours and that was because I hurt myself on a Thursday and left early. The head... View More
answered on Jul 6, 2022
If you have a claim filed through the Texas Department of Insurance, Division of Workers' Compensation, you have the right to challenge the wages your employer has listed at an administrative hearing. The easiest way is for you to get copies of your paycheck stubs to document your actual wages... View More
There were 4 witnesses to the accident, and 3 separate doctors, including a state designated doctor, stated my injury happened at work. The Designated Doctor used ICD10 codes. The original doctor used ICD9. The ALJ stated in his ruling that he didnt know why the doctor changed diagnosis codes and... View More
answered on Mar 1, 2022
You may be able to win your case in district court. The problem is that it is very time consuming and expensive to go into district court. For example, to have a doctor testify on your behalf or to even take the doctor's deposition, you are looking at about 5K. The lawyers fees in district... View More
My landlord basically said If I hire someone to work on my house then he will not pay for the labor but he didn't say if I worked on the house that I couldn't charge him for labor
answered on Jan 13, 2022
No. You would need a contract. Otherwise it would be deemed a gift. Contracts involving real estate need to be in writing. This would be a contract for services so I not too sure. Always better to have something in writing. Good Luck.
And there is something wrong with my legs and my knees
answered on Apr 26, 2021
Walmart does not carry traditional workers' comp through the Texas Dept of Insurance. They hand pick the doctors you will have to see. As a result, the doctors will usually tell you your injury is an age related issue. If you were injured as a result of negligence on the part of Walmart, then... View More
I have had three surgeries on my shoulder. I had three because I had an infection from the first surgery. The final surgery was Anterior Capsular Reconstruction. My doctor gave me a permanent weight limit restriction of 30 pounds. My profession that I have been in for 30 years requires me to lift... View More
answered on Oct 17, 2020
The best way to check your rating is to have it reviewed by your treating doctor or another person that is familiar with impairment ratings such as an attorney. The fact that you had multiple surgeries on the shoulder will not effect the rating. Essentially, the doctor will be measuring your... View More
For 2 1/2 months. Was released by a dr in a different town who told me that I would need surgery in the future. I eventually had to have the surgery last year.
Can I file on an old claim?
answered on Jun 10, 2020
If you filed your initial claim with the Division of Workers' Compensation in Texas and the specific injury is part of your work related injury, you have coverage for life for the work related injuries. This might be difficult to prove up but in theory you would still have a valid claim.
I still don't have full use of my thumb, my bone is looks like it has arthritis now but the doctor said it's because of my age ,is there anything I can do?
answered on Jun 2, 2020
You have the right to seek reasonable and necessary medical care for your thumb. You also have the right to receive a permanent impairment rating for your thumb. If you would like help with this process, feel free to contact me as follows:
email: smgesq6060@sbcglobal.net
ph. 214-358-6060
answered on May 18, 2020
Hola Me LLamo Michael Graham. Si puedo llamar mi officina es mejor. No hablo mucho espanol. Si tiene una persona qua habla English para eusted es mas mejor. Gracias.
I am being assisted by an Ombudsman, but she claims that she doesn't know of any section of the Texas Worker's Comp Law that allows an injured worker to claim payment for doctor's visits or for treatment for an accepted on the job injury. I have found during my research that... View More
answered on Apr 15, 2020
You will need to submit your pay check records to the adjuster. If you are missing time from work, you are entitled to partial TIBs for the time missed. You would be compensated at 70% of gross wages less actual wages currently paid. There is no 2 hour rule. Also, if you travel over 30 miles one... View More
So I originally got injured on 05/2019, 4 months later I was injured again. My employer was aware of what my restrictions were but still put me to work. Causing the second injury. So my second case is closed as of last week, but my injury I feel is not quite where I feel it should be? Could I sue... View More
answered on Mar 12, 2020
The state of Texas uses the carrot and stick approach with employers with respect to providing workers' compensation coverage for its employees. If they pay for the coverage, the the State prevents the employee from being able to sue the employer for negligence (not resulting in death and... View More
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