Frisco, TX asked in Workers' Compensation for Texas

Q: I have to file a lawsuit in District court against Workers compensation company. the appeal panel didn't make a statemen

There were 4 witnesses to the accident, and 3 separate doctors, including a state designated doctor, stated my injury happened at work. The Designated Doctor used ICD10 codes. The original doctor used ICD9. The ALJ stated in his ruling that he didnt know why the doctor changed diagnosis codes and thus ruled with the workers compensation company. He also stated the accident was enough to cause damage to muscles, but not cause damage to a pre-existing injury in the same area. It makes no sense. I worked as a rehabilitation specialist. If I get the doctor in front of a judge, my injury will be compensable because he can explain the ICD 10 vs ICD 9 codes. The workers compensation company also authorized initial treatment for the original injury. When they found out the extent of the injury, they denied the injury was compensable. I have 3 weeks to file a suit to fight for my health. I lost my job because they couldn't accommodate me.

Related Topics:
1 Lawyer Answer
S. Michael Graham
S. Michael Graham
  • Workers' Compensation Lawyer
  • Dallas, TX
  • Licensed in Texas

A: You may be able to win your case in district court. The problem is that it is very time consuming and expensive to go into district court. For example, to have a doctor testify on your behalf or to even take the doctor's deposition, you are looking at about 5K. The lawyers fees in district court can run from 25k - 35k for an average case. The lawyer is only able to get paid out of your benefits which is limited to 25% of what you would be paid by the Carrier if you win in district court. Given the fact that you already lost, the chance that you may loose in district court again would have to be a factor. I would analyze this as a 50/50 chance. So, in the end the lawyer has a 50/50 chance of getting paid 25% of your income benefits. If we factor this down to averages, then he would be paid 12.5% for handling cases in district court. Unless your case would generate very large income benefits for you, and, in turn, your lawyer, it's just not economically feasible for the lawyer to handle the case in district court. For this reason, I'm out as would be most lawyers. For first analysis would be to figure out what amount of money you would be paid provided you win. Then see if this would be enough to compensate the lawyer for taking your case to a jury trial.

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.