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Texas Workers' Compensation Questions & Answers
1 Answer | Asked in Workers' Compensation for Texas on
Q: Cervical fusion in 04 and Work Comp settled with stip for future med. Treating ~ '18 for >pain. WC started denying care.

I relocated to TX in 08, and continue to work for same employer. The '04 surgery did not help neck pain at all. Progressive symptoms through present. 3 radiofrequency ablations in past two years. Chrio, PT, and meds help some. Hard time finding doctors in TX that understand CA future... View More

S. Michael Graham
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S. Michael Graham
answered on Jan 17, 2018

It sounds like your case is under California law. You might need to consult with a lawyer licensed in California. If you claim was filed in Texas, you have the right to contact the OIEC and request a BRC hearing. OIEC would be able to answer some basic questions. It will be hard to get an attorney... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Had shoulder surgery and at Statutory MMI. went to DD Shoulder in sling want move how does he give IR
S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 17, 2018

If you are at Statutory MMI, the doctor must rate you. He will take measurements based upon your current physical abilities -- even if you are in a sling. This is the rating that will be used. You have the right to challenge the rating with your own rating if you do not agree with the designated... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: My girlfriend was seriously injured while working for a remodeling company in Texas she is a subcontractor ..help

The company carries wc insurance does she have a claim

S. Michael Graham
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S. Michael Graham
answered on Jan 15, 2018

This can get a little tricky. There are certain DWC forms that dictate who will be the workers' comp carrier. When you say there is coverage, are you referring to the subcontractor or the general contractor. If it is with the subcontractor, she should be covered; however, if it is with the... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: My husband was on workmans comp earlier this year.. He received a check today for 7 weeks iibs.

Doctor has said he will probably need more surgery. Does this settlement stop further benefits

S. Michael Graham
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S. Michael Graham
answered on Jan 15, 2018

If your husband is scheduled for surgery in the very near future, you can challenge the rating by filing a DWC 45 and requesting a BRC and/or CCH hearing with the DWC. If the proposed surgery just something that may need to be done in the distant future, it may not have an effect on the MMI date.... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I had a work related hearing loss 2/17, was documented by audiograms, Hearing aids were provided. are cash benefits due

I lost around 39% hearing in one ear and 49% in the other ear. after hearing aids were provided. Workman's comp insurance, avoids contact. no follow-up with me. I have documented info on audiograms hearing test, noise surveys at work. is there time limits on cash settlement benefits?

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 11, 2018

You do not provide enough facts to give you an answer. You have 30 days to report claim to employer, one year to file a claim with the Division as a general rule with exceptions in some cases. You must prove that the work caused the hearing loss. You should then be entitled to receive an permanent... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I have a Mri my question's is I had no treatment and now I have to see a doctor for max treatment can this be right

I have a herniated disc w \ sciatic down my right leg and they are calling it a back sprain

Roy Lee Warren
Roy Lee Warren
answered on Jan 10, 2018

I think you need to hire a lawyer asap because your case is on the fringe of being finalized with MMI/IR. You need to have the extent of your injury decided and you must start with your treating doctor.

1 Answer | Asked in Workers' Compensation for Texas on
Q: I have a orthopedic doctor and a urologist do I get two mmi ratings
Roy Lee Warren
Roy Lee Warren
answered on Jan 10, 2018

No but the MMI/IR could be from two different areas on your body. To get an impairment rating you have to be at MMI, maximum medical improvement, meaning you have gotten about as well as you will ever be. Sometimes medical providers refer injured workers out for evaluation to a specialist but when... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: If an employee neglected to take prescribed meds and passes out is the employer responsible for his hospital bills

We had an employee that was working out in the field at a plant for one of our projects and he passed out due to not taken his regular prescribed medication. He was rushed to the hospital and now he has bills coming in and he feels the company should pay for the bills. Not only that he thinks... View More

Roy Lee Warren
Roy Lee Warren
answered on Jan 10, 2018

This will be a factual issue to be decided by the fact finders. I have seen it go both ways on wc cases. For instance many times the DWC will look to the instrumentality of the injury. If for instance the worker was on a rig and fell off hitting his shoulder on the ground the DWC has held the... View More

1 Answer | Asked in Contracts, Employment Law and Workers' Compensation for Texas on
Q: Working without contract on IT project. Started 2nd job to make ends meet (IT project taking months). Hurt on 2nd job.

I was unable to complete the IT project because I was injured on the 2nd job. I had completed hundreds of hours of IT work and had about 200 hours to finish the project. The company I was working on the IT project for says they are not going to pay me. I sent the invoice to the company I did the... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 10, 2018

You should have a contract. A contract can be written or verbal. Obviously, its much harder to prove up a verbal contract, but if you can then they would owe you the money. I'm not too sure how much they owe you. This may effect where a lawsuit would need to be filed. You should get an email... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I am currently on WC here in Texas seeing a doctor that is approved on their list is sending me back to work with LDuty.

I wanted to know what are my rights if I dont agree and because I didnt know about not taking the WC check can I give it back and pay for my own medical bills and see my own doctor and sue them in the process?

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 10, 2018

You may be able switch doctors without having to pay out of your own pocket. If it’s your first change and a non network claim, you could switch to any doctor willing to treat under certain circumstances. If it’s a network you can also change to a doctor in that network. You can always pay out... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I received a workmans comp check. I tried to cash the check. And numerous check cashing establishment's denied it.

The check is from citi bank. Closest citi bank to me is 2 hours away. What is causing the check cashing establishment to deny the payout?

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 8, 2018

I'm not sure why the check cashing place is denying. If it is workers compensation and you have a checking account, you can set up a direct deposit account with the workers' compensation carrier to hopefully avoid this problem in the future.

1 Answer | Asked in Workers' Compensation and Employment Law for Texas on
Q: This is a difficult question in my eyes, I work for a company who require's you to use your personal truck for work.

I pick up trash at night time. I'm required to use my flashers at all times when the vehicle is parked even though I have 2 magnets, one inside and outside my vehicle that say who I work for. If my vehicle battery dies due toflashers draining the battery, am I allowed to submit a claim with my... View More

Roy Lee Warren
Roy Lee Warren
answered on Jan 5, 2018

This is not really a wc question but I will answer for you. Go to the website below and it should give you the answers you seek because it provides information on what workers in Texas (not sure about Florida) are entitled to be paid for. Good luck to you.... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I’m scheduled for ACL surgery tomorrow... how to proceed? Help...

I’m an Art Director who also organizes the company party’s & functions. It was the end of our holiday function, I was cleaning, an intoxicated coworker waiting on a sober ride who was wearing 3 inch heals took a tumble using me to stop her fall she pivoted us in a spin to the ground with... View More

Roy Lee Warren
Roy Lee Warren
answered on Jan 5, 2018

There is an old (? before I was practicing law) Texas Supreme Court (TSC) Decision that ruled if one of two insurance carriers (health care insurance or workers comp carrier) owe benefits to a person they are to pay and basically figure out who owes between them. Making the injured party pay was... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: My benefits stopped because my adjuster said I was observed doing things above my Dr restrictions. But it was not above

I was loading boards on a trailer. My restriction is 20 lbs for the one arm. The boards I was picking up did not weight 20 pounds

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 4, 2018

If the adjuster will not pay your TIBs benefits, then you have the right to attend a hearing with the Division of Workers' Compensation to challenge her decision. If you prevail, she will owe you all back TIBs benefits. You have the legal right to hire a lawyer of your choice, to protect your... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Workers comp specific: Trying to understand how a claim works if I have ACL surgery scheduled tomorrow before approval

I’m an Art Director who also organizes the company party’s & functions. It was the end of our holiday function, I was cleaning, an intoxicated coworker waiting on a sober ride who was wearing 3 inch heals took a tumble using me to stop her fall she pivoted us in a spin to the ground with... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 3, 2018

There are several issues presented in your facts. You need to report your injury to your employer. You should have your surgeon get the surgery preauthorized under workers compensation even if you have the surgery on your private health. You should submit the claim to the workers' comp carrier... View More

1 Answer | Asked in Workers' Compensation and Child Support for Texas on
Q: On 02/07/17 I was given a Back Impairment Rating on 02/27/17. I received and signed for DWC032 instead of copies of test

I start call State of Texas on 05/15/17 ..about Impairment results copies and before my 90 dsys had passed on 09/28/17. given IME test which said I haven't reached MMI....now about to go to CCH

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Dec 18, 2017

I'm not too sure what your question is. It sounds like you are going to a CCH to determine if you are at maximum medical improvement and what your current impairment rating is. You will likely need a DWC 69 report from a doctor that supports your position at the CCH. You should consult with a... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Can a workers compensation adjuster request a mmi, impairment rating if you have not been released by the doctor?

I had surgery on shoulder in June and I have not been released by the surgeon or the workers compensation doctor in which they sent me to see when i got hurt to return work. My adjuster requested a mmi, impairment rating and a return to work evaluation from another doctor.

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Dec 18, 2017

Because the Carrier pays for your surgery and other income benefits, they have the legal right to request for MMI and IMP even though your treating doctor may disagree. They first have to request a state selected doctor (designated doctor) and then they can request another doctor of their own... View More

1 Answer | Asked in Employment Law and Workers' Compensation for Texas on
Q: I injured my shoulder while on the job site. If I choose to go to my orthopedic doctor do I lose my WC benefits?

I have been going to therapy for over three weeks and have not had any significant improvement in mobility. The Dr. Is at a Urgent Care type place, and I don't feel that the treatment being given is effective. My H.R. told me that if I choose to go to my personal Dr. I lose WC.

Roy Lee Warren
Roy Lee Warren
answered on Dec 5, 2017

No you do not lose wc benefits, however, the insurance carrier may not have to pay your personal doctor. Also you may also have to continue to see their doctor in order to get income benefits because they may not honor you personal doctor, particularly if they have "network" doctors. If... View More

Q: Should I be getting paid?

Im an assit. Manager for apartments in texas, owned by a corporate. My Contract says m-f 1pm-5:30pm free rent on an apartment on site. If they ask me to work other hours outside of the 1-5:30pm should I be getting paid actually $$ for those hours?

Roy Lee Warren
Roy Lee Warren
answered on Dec 5, 2017

This is not really a wc question but I will point you in the right direction to get your question answered. I will post the website for you below regarding the Texas Payday laws. Good luck to you.

http://www.twc.state.tx.us/jobseekers/texas-payday-law#paymentsSubjectToPaydayLaw

1 Answer | Asked in Personal Injury and Workers' Compensation for Texas on
Q: A heavy box fell on my head while in UPS orientation & my neck hurts badly They made me sign some paperwork while dizzy

I was in an orientation at UPS they sat us down to watch a training video but while I was watching a heavy box fell on my head from approximately 11-13 feet it made me dizzy and nauseous afterwards and they asked me to sign some paperwork so I could go to a doctor or something I can't really... View More

Roy Lee Warren
Roy Lee Warren
answered on Dec 5, 2017

Employers c/n require you to waive a wc claim so if that is what you are worried about put you mind at ease. Also it does not matter if you were hurt during orientation, it is still compensable. Call UPS and ask which medical provider you should see and for a copy of the document you signed. I do... View More

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