Q: The adjuster is telling me that medical benefits are approved but no wages since my job is sedentary, what can I do?
I just started this job and one month in, I fell and injured both knees and now I am experiencing severe pain and swelling in my legs. I filed my claim the next day but my employer advised me it was not WC. A few weeks later an adjuster contacted me to follow up telling me it was WC. I advised her that I was having difficulty sitting for 8 hrs, bending my knees to sit and needed to see a doctor since I am in pain all the time. I have missed work due to increasing pain. Somedays the pain is so great I am not able to sleep. Now the doctor I saw gave me 4 weeks off but the employer is disputing that my job is sedentary so my time off requests are denied and not considered WC. They also advised that since I just started I don't have PTO so I can be fired for taking time off. The adjuster also advised that wages would be denied because I did not initially take time off besides the day after the injury. Is there anything that I can do at this time?
A: You need to determine if your claim is through the Texas Dept of Insurance or if it is a self-insured occupational injury claim. If it's through the Texas dept of Insurance, Division of Workers' compensation, then you need to file a DWC 41. Find out who your adjuster is, get claim number. Then get to a network or non-network doctor as appropriate. My advice is to contact a local attorney to assist you because it looks like you are going to have some legal issues with this claim. Most attorneys will speak to you over the phone for free. My office does.
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.
