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Questions Answered by S. Michael Graham

1 Answer | Asked in Workers' Compensation for Texas on

Q: Is a stroke on the job a claimable workers comp claim?

My company claims it's not job related. I am a construction manager in a highly stressful position.

S. Michael Graham answered on Jul 26, 2018

It could be work related but you will need an expert medical opinion to state that it was work related. The medical expert will need to explain what you were doing that day caused the stroke. I don't think you could claim that since you have a very stressful job, that over a period of time, then... Read more »

1 Answer | Asked in Workers' Compensation for Texas on

Q: Can my fiancé decline workers comp for an accident?

My fiancé got into a minor accident while on the job. He refused medical treatment as he felt fine and there was no bleeding, just minor bruises. He finished up the work day with no problems but the next morning he woke up with his body feeling a bit sore and decided just to call in sick. He did... Read more »

S. Michael Graham answered on Jul 25, 2018

If your husband missed a day of work, the employer is required to file a claim. He doesn't have to go to the doctor if he doesn't want to or he doesn't feel injured. If he is injured, he could also go to his own doctors and pay out of his own pocket instead of having workers' comp pay 100% -- dumb... Read more »

1 Answer | Asked in Workers' Compensation for Texas on

Q: I feel I’m being forced back to work by my Dr and insurance co. They’ve suspended my benefits. What can I do?

Benefits have been suspended. Dr’s office won’t submit updated status and work report adjuster needs every 30-45 days to release benefits. Dr says all insurance will pay for at this point is surgery. Adjuster says they’ll cover whatever Dr request. See the circle? I have a herniated disk at... Read more »

S. Michael Graham answered on Jul 12, 2018

The general rule is that the ODG Guidelines recommend the least invasive treatment before engaging in more invasive treatment such as surgery. The protocols for each type of injury would be different. ODG will usually only allow limited therapy and injections. Your next step would be surgery if he... Read more »

2 Answers | Asked in Employment Law, Workers' Compensation and Car Accidents for Texas on

Q: My son works for Domino's Pizza in TX, and he was in a car accident (fault of the other person) while on a delivery.

He was told that he has whiplash and some bruising to his left shoulder causing him to miss work. He was checked out by the company's physician and although she confirmed the whiplash and bruising to his left shoulder, prescribed him some Motrin and a muscle relaxer, she cleared him to return to... Read more »

S. Michael Graham answered on Jul 10, 2018

If the employer purchased a policy of workers' compensation, your son could get his medical expenses and lost time paid through the workers' comp carrier. You cannot collect pain and suffering under workers' comp because it is a policy of insurance only. Your son could make a claim against the... Read more »

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1 Answer | Asked in Workers' Compensation for Texas on

Q: If I cannot find a lawyer to represent me,do I have to use an ombudsman ?

I am going to my 2nd brc hearing.

Cannot find a lawyer willing to represent me.

Have no faith in these ombudsman.

Feel like Im being ushered into a screwing.

Please help.

S. Michael Graham answered on Jul 4, 2018

Make sure you consult with an attorney that handles workers comp. If an attorney will not assist you, you probably will be stuck with the ambudsman assistance program.

1 Answer | Asked in Workers' Compensation for Texas on

Q: I was fired instead of being allowed to return to work. I am still under docs care. Should I still be getting a check?

My employer refused to accommodate the docs restrictions. I received comp for lost wages up until the day those restrictions were lifted. However, my employer refused to let me return to work and instead fired me! I am still under docs care and am having a second surgery for the injury. Is WC... Read more »

S. Michael Graham answered on Jun 28, 2018

You should still be entitled to income benefits and reasonable medical care. You may need a hearing to get these matters settled. My advice is to contact an attorney experienced in workers' compensation law. A lot of attorney's will speak to you for free over the phone. Feel free to call me.... Read more »

1 Answer | Asked in Workers' Compensation for Texas on

Q: What reasons after surgery did my benefits get cut off? And therapy denied

S. Michael Graham answered on Jun 21, 2018

You question is not specific enough to provide a meaningful answer. Call a competent attorney to discuss your issues. Most workers' comp attorney's will speak to you for free over the phone. Just make sure the attorney handles administrative hearings before the DWC.

1 Answer | Asked in Workers' Compensation for Texas on

Q: if I applied for workmans comp. in Texas. do I have to notify any one if I find new employment?

S. Michael Graham answered on Jun 16, 2018

No. Workers comp claims are confidential unless they reach the district court level.

1 Answer | Asked in Workers' Compensation and Insurance Bad Faith for Texas on

Q: Insurance company is refusing to pay my father's life-time settlement agreement for 4yr now which is to pay 15k/yr

He was awarded in court a life-time settlement. We have all the paperwork and even the original checks from the initial payout. However the company that is now supposed to pay the 15k per year is refusing to pay. Calling them just sends you from employee to employee, in circles. One lady flat out... Read more »

S. Michael Graham answered on Jun 6, 2018

You can contact an attorney of your choice or else you are free to contact my office.

An attorney will need to review the file and paperwork to determine what benefits are due and owing. My website is www.onthejobinjury.info. Ph. 214-358-6060

1 Answer | Asked in Workers' Compensation for Texas on

Q: Can contract workers get workers' compensation for injuries caused on the job?

S. Michael Graham answered on Jun 4, 2018

If you are truly an independent contractor for an employer you wouldn't be covered under workers compensation. However, if you are a contract worker and a temporary employee, then you would be covered. If you are an independent contractor and somebody else was negligent in causing your injuries you... Read more »

1 Answer | Asked in Workers' Compensation for Texas on

Q: injured 4y ago working for a city in texas, mmi was 52% impared 100% disabled. cant work iib ended ssdi750 what do i do?

i ruptured 2 discs in neck and one in back from,falling head first off a dump truck i was working on without proper equiptment available, was told by wc i couldnt sue the city for my injury and wc was only temporary even though i can never work again, i had surgery for 1 disc in neck, i have lost... Read more »

S. Michael Graham answered on Jun 4, 2018

If you do not qualify for LIBS and your IIBs have run out, you can still apply for SIBS. You have to document an "active effort" to seek employment within your work restrictions. These SIBs benefits are available for 401 weeks from your date of injury.

2 Answers | Asked in Workers' Compensation for Texas on

Q: Can my employer legally attend my workmen's comp doctors visit? I'm in Texas.

I work for a manufactured homes business and I hurt my lower back on the 3rd time I hurt it they finally took me to the doctor and the safety manager took me. She then walked in to the appointment with me and sat down and even talked to the doctor. Then did the same thing for the follow-up today.... Read more »

S. Michael Graham answered on May 31, 2018

Your employer may not attend the doctor's appointment with you if you do not choose. This is private healthcare. This might cause problems with the employer, however. You would also need to know if it is workers' comp through the Division or an occupational injury plan. A plan is self-administered... Read more »

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1 Answer | Asked in Workers' Compensation for Texas on

Q: If it's my first time getting hurt on the job can they ask for medical records?

S. Michael Graham answered on Apr 11, 2018

You do not have to provide your medical records. However, the Carrier can deny your claim also. If you put your medical at issue, the Carrier will have a right to look at your medical before they become legally obligated to accept your claim.

2 Answers | Asked in Workers' Compensation for Texas on

Q: Why would they ask for medical records on workers comp?

S. Michael Graham answered on Apr 9, 2018

The workers' comp insurance company wants to verify that you haven't injured the claimed body part in the past. This is the main thing past medical history is requested. They need your current workers' medical to pay the bills.

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2 Answers | Asked in Workers' Compensation for Texas on

Q: Can a Designated Dr put me at MMI with IR without me been present & PTP acceptance of the IR and MMI date of his repo

My first DDE was on 12/20/2106 @ that visist the Dr had me at NOT reached MMI with a possible statuary date.

The second DDE was on 3/20/2018 he certified me with MMI / IR on that date , with retrospective date of 6/13/2017 is that possible ? My PTP never certified , signed any MMI /IR for... Read more »

S. Michael Graham answered on Apr 4, 2018

The DD must see you and do a physical examination to place you at MMI. However, as long as he does see you, the DD is free to back date the date of MMI. He doesn't actually have to see you on the back dated, date. The doctor doesn't need to have permission from anyone else to do this rating. You... Read more »

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1 Answer | Asked in Workers' Compensation for Texas on

Q: I had an accident while traveling on business and paid out of pocket expenses for the first 2 weeks before Workers Comp

I am told there are limits t what I will get paid back but cant find the details. How do I go about getting the insurance company to pay my out of pocket expenses.

S. Michael Graham answered on Apr 3, 2018

Workers' compensation is an insurance policy, so it will not cover typical out of pocket expenses like food, clothing, driving to the doctor's office (unless over 30 miles one way), gas. For example, if you use your private health like Blue Cross, you wouldn't ask them to pay out of pocket... Read more »

Q: Hello sorry to contact you so early but I need advice due to harrasment on my job from supervisor.

I have been employed with United Healthcare since 2009 a new supervisor was transferred to our company from Florida. I received a letter stating I will be terminated as of 4/2/18 even though I did not voluntarily quit. My insurance was all so cancelled I am still under psychiatric care due to I had... Read more »

S. Michael Graham answered on Apr 3, 2018

Mental trauma injury is not covered by workers' compensation unless it involved a one time event resulting in the trauma. If you have issues with your supervisor who is discriminating against you because you have an injury, you will need to consult with a labor and employment law attorney. Good... Read more »

1 Answer | Asked in Employment Law, Workers' Compensation, Medical Malpractice and Small Claims for Texas on

Q: Can I do something about all this things that are going on with this doctor? not all details were included.

My employer is a specialist that performs oral surgeries. Her assistants are phlebotomist and not surgical assistants nor dental assistants, but they are next to her doing surgery with very minimal to no training. She has them taking x-rays without a license. She also leaves out of town and the... Read more »

S. Michael Graham answered on Mar 29, 2018

These are potential violations of the law which need to be addressed by the appropriate agencies like the state medical board, health department, OSHA, or district attorney's office. These violations do not fall under workers' comp which deals primarily with injured workers.

1 Answer | Asked in Workers' Compensation for Texas on

Q: My husband WC claim was denied after receiving payment for 8 wks due to a medical statement being incorrect. What to do?

The admitting physical was contact and confirm that the statement was wrong and offer to do what was need to get this corrected. We did start the appeal process. My question is should we contact the WC claim adjuster and let the physician speak with them confirm the incorrect diction of the medical... Read more »

S. Michael Graham answered on Mar 28, 2018

Unfortunately, the adjuster is not on your side. My advice is to contact a workers' comp attorney. It sounds like you are in for a fight. If you can get the ER doctor to write an amendment or correction to his notes then that would be very very important to try to get that done. The judge will go... Read more »

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