Lake Jackson, TX asked in Workers' Compensation for Texas

Q: How long is the wait to receive my worker's compensation check

The injury happened at work and was being looked at by a Doctor through worker's comp and then he discharged me saying there was nothing else he can do for me so now I got a worker's comp lawyer and went to another Doctor only to be ridiculed by him saying that I was over weight and that my back injury was over exaggerated and then my physycal therapy is not till 2 weeks and my lawyer just said to give the doctor a chance that it will look bad for my case if i change doctors and still waiting on my check to pay bills how long does it take to recieve a check I'm from Texas if that helps

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

A: If your medical provider has you off work the insurance carrier has 7 days to pay or dispute. It has 15 days to investigate to determine if you have a compensable injury.

The law provides as follows: An IC is liable for accrued benefits if it fails to dispute compensability of the injury within 15 days after receiving written notice of the claimed injury. Section 409.021; Section 124.3(a)(1). If the IC disputes compensability of the claimed injury after 15 days, but within 60 days of receiving written notice of the claimed injury, the IC is liable for all accrued benefits up until the time of dispute. Section 124.3(a)(2). Once the IC files a dispute with the Division, before the 60th day after receiving written notice of the injury, the IC is no longer liable for further benefits unless the Division determines that the injury is in fact compensable.

If the IC fails to dispute compensability of the claimed injury within 15 days of receiving written notice, but does successfully dispute compensability within 60 days of receiving written notice, and if the IW is being treated in a network as provided for in House Bill 7, Section 8.016, the IC's maximum liability for accrued medical benefits prior to the dispute is limited to $7,000.00. Texas Insurance Code Section 1305.153. The $7,000.00 limit is effective for claims with a DOI on and after the date of the contract establishing the certified network.

If the IC does not dispute the claimed injury within 60 days after it received written notice of the claimed injury, the IC waives the right to dispute the compensability of the claimed injury unless the IC can prove that there is newly discovered evidence that could not have reasonably been discovered earlier. Section 409.021(d). An IC that contests compensability of the claimed injury after 60 days on the basis of newly discovered evidence is liable for, and must continue to pay, all benefits due until the Division has made a finding that the evidence could not have been reasonably discovered earlier. Section 124.3(c)(2).

Hope this helps.

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