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Questions Answered by S. Michael Graham
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... View More

S. Michael Graham
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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
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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... View 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... View More

S. Michael Graham
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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.... View More

S. Michael Graham
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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... View 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
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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
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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... View More

S. Michael Graham
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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... View 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
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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... View 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... View More

S. Michael Graham
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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.... View 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... View More

S. Michael Graham
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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... View More

S. Michael Graham
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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... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: What happens if workers comp is wanting me to go back to work when i feel i'm physically unable.

It has been 3 years already and i have goen through temporary benefits and received an mmi of 60% and still collecting those benefits. I still have at least 3 surrgeries to go until i'm done. What can they do if i refuse to do restricted work at a sandwhich shop, probably the only thing i... View More

S. Michael Graham
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S. Michael Graham
answered on Mar 26, 2018

You probably would be best advised to contact a workers' comp lawyer on the phone. It sounds like you are entering supplemental income benefits phase of your case. There are many legal rights and responsibilities that you need to be thoroughly familiar with in order to obtain these benefits.

1 Answer | Asked in Workers' Compensation for Texas on
Q: I just had my mmi and ir. I refused surgery, so the Dr said he would use my last measurements, is this backdating?

Will this hurt my chances of getting compensated? He said my hand and shoulder hasn't gotten better. I had surgery on my hand a year ago and it didn't go well...my reasoning for not wanting surgery on my shoulder. So he said he would probably use the same measurements from the previous mmi.

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Mar 26, 2018

I would think the doctor would take new measurements unless you are past your statutory MMI date. You are not required to have surgery. That is a personal decision. If you do not receive additional treatment, then the doctor will often use a date occurring before your visit with the doctor (back... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I have an attorney who does not return my calls or emails. I am on workers comp & cannot get the help I need. I'm now on

Medicare & having to use my personal insurance to get help. Workers comp is not helping me or paying an of my bills

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Mar 23, 2018

An attorney should respond to you within a reasonable amount of time. If your attorney will not respond to you, you can file a DWC 150A form to release your attorney from representing you. You can then possibly seek new representation if that is what you want.

1 Answer | Asked in Workers' Compensation for Texas on
Q: My husband was severely burned at work (2nd degree to hand/wrist/forearm and neck). No impairment rating assigned?

My husband was severely burned at work (2nd degree to hand/wrist/forearm and neck). He returned to work after being out 2.5 months (10 weeks). He received 70% pay while out and medical expenses paid, but no impairment rating when returning to work. Is this the end? Will no more impairment... View More

S. Michael Graham
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S. Michael Graham
answered on Mar 8, 2018

My office can help to ensure that your husband receives a rating for his injury. We also work with medical professionals can can help to review the ratings to make sure they are fair and correct. We often have to challenge ratings before the administrative law judge.

When you get a chance,...
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1 Answer | Asked in Workers' Compensation for Texas on
Q: I received notice of disputed issue and refusal to pay benefits. What is the time frame I have to respond ?
S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 26, 2018

I would need more information to know exactly what they are disputing. Is it your whole claim? Is it the extent of injury? Is it the impairment rating? Depending on what has been disputed, you will be subject to different time frames. My advice is to contact a workers' comp attorney on the... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I was injured 5 months ago and I'm still on wc injury was a 18 wheeler ran over my right foot broke my ankle, all bones

And had to have a skin graft that's is half of my lower leg Dr says he's releasing me to light duty work but with my job that includes standing at hours end and I can barely stand for an he without pain I'm worried that I'll never be able to do my occupation ever again and do... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 19, 2018

If you are unable to stand and you have not been placed at maximum medical improvement for your injuries, then you can be paid while you are recovering from your injuries. You should also be entitled to a permanent disability rating. I'm not too sure if it would qualify for the skin graft... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I been getting Workman comp and if I Lea ave the job and go to another will I still get Workman comp
S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 14, 2018

If you quit, you will not loose your workers' compensation benefits for that reason.

1 Answer | Asked in Workers' Compensation for Texas on
Q: WHAT IS THE TIMELINE FOR A CLAIMS ADJUSTER TO APPROVE MEDICAL SERVICES ON A WORKERS COMP CLAIM?

SOME HAVE SAID THEY HAVE TO APPROVE SERVICES WITHIN 72 HOURS, THIS IS FOR DURABLE MEDICAL EQUIPMENT (DME)

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 14, 2018

The approval is authorized by the utilization review company that the Carrier subcontracts with. For Emergency there is no time line. For some emergencies it will be 72 hrs. For general denials it will be 3 or 7 days to respond to the request. Some DME less than $500.00 I believe doesn't... View More

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