Houston, TX asked in Workers' Compensation for Texas

Q: Can workers comp doctor's make one use their own private insurance?

I work for a veterinarian and I got bit at work by a dog. The WC doctor said my thumb is fractured so on my third visit he said I was able to use it. Now I have a lot of pain and a not where my thumb meets my hand he said its arthritis now. I didn't have this issue before its painful to turn the ignition key in my vehicle.

He said he can fix it through my private insurance.

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2 Lawyer Answers
S. Michael Graham
S. Michael Graham
PREMIUM
Answered
  • Workers' Compensation Lawyer
  • Dallas, TX
  • Licensed in Texas

A: If the arthritis is due to the dog bite, then this would be workers' comp provided your employer carries workers' comp coverage for its employees. Most Carriers have networks in place which means you have to choose a network doctor. I would advise you to contact an work comp attorney to discuss the facts.

Roy Lee Warren agrees with this answer

1 user found this answer helpful

Roy Lee Warren
Roy Lee Warren
Answered
  • Workers' Compensation Lawyer
  • San Marcos, TX
  • Licensed in Texas

A: I thank you for your question. Mr. Graham, a well qualified wc lawyer has already answered but I would also like to add a bit more information for you.

As Mr. Graham noted most employers have switched over to "networks" which is incorrectly said to be a network of medical providers created by employers for injured workers to go to. The network is actually set up by insurance carriers b/c they are more familiar with the providers that will be carrier or employer friendly. Injured worker friendly providers are regularly excluded from these networks.

The provider that advised you to go to your health insurance doctor has given you poor advise for several reasons.

First, co-pay or deductibles likely have to be paid. Next, you probably would not be entitled to reimbursement for medical expenses (or mileage) if the condition you seek treatment for subsequently became compensable.

As Mr. G states, you should consult with a WC lawyer or at least ask DWC to appoint an ombudsman to assist you with your case. You probably need to request DWC to appoint a designated doctor to address your the extent of your "compensable injury". Best of luck to you.

1 user found this answer helpful

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