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Texas Workers' Compensation Questions & Answers
1 Answer | Asked in Workers' Compensation for Texas on
Q: Do I have to have a close MRI, when I asked for an open one because I am claustrophobic
S. Michael Graham
PREMIUM
S. Michael Graham
answered on Mar 7, 2017

I have never seen a problem with getting an open MRI when someone feels uncomfortable. You might try switching to a different MRI facility if they can't do it. You can contact your wc adjuster to discuss it.

1 Answer | Asked in Workers' Compensation for Texas on
Q: Am I eligible for income benefits for a follow up surgery a year after my claim?

I broke my hip on the job a year ago, and my surgeon is now recommending a follow up surgery to remove my surgical hardware and remove a bone spur that is likely to cause further damage if left alone. He estimates a six week recovery period after the surgery. Is my Texas workers comp provider... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Mar 4, 2017

If you have already received your impairment rating and it has been over ninety days since you received it, then you would not be entitled to additional temporary income benefits. There are exceptions to the 90 day rule, but I don't think the facts of your case would qualify. However, you... View More

2 Answers | Asked in Personal Injury, Workers' Compensation and Employment Law for Texas on
Q: I'm in dallas, tx. Is the company supposed to pay us for doctors appointments not on company time or on company time?

I had a second doctors appointment on company time and had to use my PTO in order not to get pointed (we work on a point system at work) for being late.

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Mar 3, 2017

Travel in the form of milage request can be submitted for payment to Designated Doctor exams and RME exams. Your time would be calculated through your temporary income beneits. But basically, the answer would be No. For more detailed information, your advised to consult with a workers'... View More

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1 Answer | Asked in Workers' Compensation for Texas on
Q: TX workers comp cases never close - how do you handle a denial from medicare where injury is not related?

Person on medicare had a workers comp claim and all was resolved 3 years ago. Treatment as a result of current injury to another part of body is being denied by medicare and even denied on appeal. What is needed to prove to medicare this is not a workers comp issue?

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Mar 2, 2017

Have the medical provider submit the treatment through workers' compensation utilization review department for the workers' compensation carrier. The utilization departement will approve and/or deny based upon reasonable and necessary. If it is approved then see if the workers'... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: my son is 17 and got hurt at his job, the manager is acting funny. how do I know if he really filed for workers comp?
S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 24, 2017

You don't. You can call the DWC to see if a claim has been filed. But it's your responsibility to take affirmative steps to make sure the claim is established. Don't sit back and play the victim. You need to determine who the workers' compensation carrier is, and also file your... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: What are laws for an injury from your own fault and also not reporting it right away even though a supervisor knew?

Husband hurt himself at work and it was his fault. Afraid of losing his job, he didn't report it and thought he'd just see "how it felt the next day" because he didn't think it was that bad. His immediate supervisor knew he was hurt, just not the details. The next day,... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 24, 2017

The first thing you need to know is what type of policy your husband's employer has. Is it a policy of workers compensation through the Texas Department of Insurance (subscriber) or an self insured, self administered by the company, occupational injury plan. If it's an occupational injury... View More

1 Answer | Asked in Workers' Compensation and Business Law for Texas on
Q: I'm currently on workers comp and received one TIB Check... Will the carrier send my funds weekly or bi-weekly?
S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 24, 2017

Your checks will be sent on a weekly basis. Make sure your adjuster is kept up to date on your work status. It's your responsibility to get work restriction documentation to the adjuster.

1 Answer | Asked in Workers' Compensation for Texas on
Q: I'm almost a year into my claim. The nurse case manager told me it I should retire before my year is up

I was just denied surgery this month that's when the nurse case manager called me to tell me to retire or request going back to work from The Specialist this is a back injury

Roy Lee Warren
Roy Lee Warren
answered on Feb 23, 2017

That seems a bit fishy to me that the NCM would give you advice to retire? If you have no lawyer assisting you you should call DWC and ask for an ombudsman to be assigned to you case. You need to ask for reconsideration on the denial of surgery (w/i the time limits imposed) and if denied again ask... View More

1 Answer | Asked in Workers' Compensation and Employment Discrimination for Texas on
Q: I am asking for advice on behalf of my mother, her employeer has stopped paying wages for workmen's compensation.

The wages have stopped with out notice. We spoke to the insurance adjuster handling the claim and she stated she would check with the employeer for the status or reason of the missing wages. Due to not receiving these wages my mother was not able to purchase her prescriptions that she needs to... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 23, 2017

You will probably need to speak to a lawyer to get your answer because there is just not enough information to answer your question. Most workers' compensation lawyers will speak to you for free over the phone. The answer will depend on whether your mother's claim is under workers'... View More

2 Answers | Asked in Employment Law, Personal Injury and Workers' Compensation for Texas on
Q: I was on my way to work just parked in a parking garage across the street from the place of my employment.

I was hit as a pedestrian by a pickup truck in the garage and injured. My supervisor days later filed a Workers Comp claim. Now our worker's comp insurer keeps calling me to complete paperwork. This is clearly a personal injury case and I've already retained a personal injury attorney... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 16, 2017

The general rule is that "course and scope" of employment does not coming to or leaving work. However, as with all laws, ther are exceptions. Your case may very well be covered by the "access doctrine". You will be covered as soon as you arrive at work even if you are not on... View More

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1 Answer | Asked in Estate Planning, Probate, Real Estate Law and Workers' Compensation for Texas on
Q: Is there an attorney that i can use for mutiple reason.probate.realestate .workmanscomp.liscense .lawsuit
Beatriz Adriana Sosa-Morris
Beatriz Adriana Sosa-Morris
answered on Feb 15, 2017

It depends on the attorney. Some attorneys focus on multiple areas of the law, while others only focus on one or two. Good Luck.

1 Answer | Asked in Workers' Compensation and Employment Law for Texas on
Q: I was a CDL driver when I was injured IN 2013 and am now returning to a driving career, I was given a wrongful reference

My old employer gave false dates and put that I was injured and had hired an attorney for my injury. They made it sound as if I was a risk to hire because I had hired an attorney when I was hurt on the job with my old employer. The new company I applied at denied me employment due to this reporting... View More

Beatriz Adriana Sosa-Morris
Beatriz Adriana Sosa-Morris
answered on Feb 15, 2017

You may want to look at the settlement agreement you entered into with your old employer over the work related injury. It may include a "mutual non-disparagement" or require the old employer to give you a neutral employment reference.

2 Answers | Asked in Personal Injury and Workers' Compensation for Texas on
Q: I work in TX. I had personal leave days. I was told I had to use my leave 4 an injury on the job b4 WC to pay. True?

I only had 3 days of leave before i got injured which was no fault of my own. I was told I had to use my leave days b4 WC paid any benefits for me missing work. Now once I able to return to work if myself or my child gets ill and I have to take off. I will be docked for a day off work bc my leave... View More

Peter N. Munsing
Peter N. Munsing
answered on Feb 15, 2017

You don't have to use the P days but they dont have to pay you for the first 5 days you are out. These are work/business days, days when you would be on shift.

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2 Answers | Asked in Personal Injury and Workers' Compensation for Texas on
Q: I cut my thumb off about 5 to 5 1/2 months ago I was promised things and didn't go as planned am I still able to sue ?

Boss just told me to take home all the material and I had two days to get it done getting to work a board tugged pulling my hand into the table saw cuting my thumb off and just a surface cut here and there

Peter N. Munsing
Peter N. Munsing
answered on Feb 15, 2017

Yes and you may have a case with the manufacturer of the saw. Contact a member of the Texas Trial Lawyers Association who handles "product liability" cases as well as workers compensation. They give free consults.

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2 Answers | Asked in Workers' Compensation for Texas on
Q: Had spinal fusion last year and recently hurt my back at work. Can I get denial turned around?

I had an mri and discography prior to my surgery on my l5/s1. Mri showed no issues with l4/l5. Discography showed very minor ddd but no other issues.

Stormy night at work, power went out and I tripped over small heater. Did not fall. Then on way out side the door blew open and I reached... View More

Roy Lee Warren
Roy Lee Warren
answered on Feb 12, 2017

Surgery can be very expensive so you can expect a fight from the insurance carrier. You need to either hire a lawyer to help with your claim or ask DWC to appoint an ombudsman to assist you. Good luck.

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1 Answer | Asked in Personal Injury and Workers' Compensation for Texas on
Q: I had personal leave days. I was told I had to use my leave days 4 a not at fault injury on the job for WC to pay. True?

I only had 3 days of leave before i got injured which was no fault of my own. I was told I had to use my leave days b4 WC paid any benefits for me missing work. Now once I able to return to work if myself or my child gets ill and I have to take off. I will be docked for a day off work bc my leave... View More

Roy Lee Warren
Roy Lee Warren
answered on Feb 10, 2017

I am having a great deal of difficulty understanding your question. Are you asking if the employer can tell you to use your personal leave days after you were injured at work? Whether that would be proper depends on who your employer is. Governmental entities give employees a choice of taking... View More

2 Answers | Asked in Workers' Compensation for Texas on
Q: Injured in 2013, no longer w/company. I have a Doc for my injury, but company joined network. Do I have to switch?

I left company in 2014, they switched to network in 2017. Do I have to switch to network doc (Concentra or CareNow are my options)?

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 6, 2017

I'm not 100% on this answer, but I believe you will need to switch to the network doctor. You can have the Carrier send you the website to search out which doctors are in network. You might try calling the Division of Workers Compensation in Austin to speak to someone that deals with the... View More

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1 Answer | Asked in Workers' Compensation for Texas on
Q: Does workers comp have to give me notice before terminating my weekly benefits?

I have been getting weekly benefits since 3/22/16 do to a back injury. My surgery was on 3/22/16. I have since filed a complaint with the insurance board against the insurance adjuster (Oct 2016) due to her bullying me over my care. My checks have been coming later and later in the week since... View More

Roy Lee Warren
Roy Lee Warren
answered on Feb 3, 2017

I can guess who the IC is. I am sorry for your difficulty. No they do not have to notify you before they just stop benefits. In fact if you are certified as being at MMI and the %$#^ medical provider back dates your MMI date the IC could even say you have been overpaid. For instance, assume the... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Multiple fractured ribs. Dr trying to send me to work after two weeks. What can I do? We don't have light duty positions

I also have a floating cartilage the ER found after ambulance had to come. This was after seeing company dr. They have tried to send me back to work twice in less than two weeks. I'm in Baytown Texas and I don't know what to do. Still haven't heard from workman's comp either

Roy Lee Warren
Roy Lee Warren
answered on Feb 2, 2017

Unfortunately your employer is probably in a "network"? A network is an entity of medical providers that is approved by the IC and employer. You have your choice of medical provider as long as you choose one of the doctors they have said you can choose. (What a deal!) If your employer... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: How do I appeal a workmanship comp denial? I got a second opinion from a neutral doctor and want to appeal

I had a ACL tear

Roy Lee Warren
Roy Lee Warren
answered on Feb 2, 2017

I'm not clear as to what you are asking. Was there a CCH and you lost or are you asking how to appeal a preauthorization request. If you want to appeal a preauth you must ask for reconsideration within the time limits. If you just want to fight the IC's denial of medical benefits for the... View More

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