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Texas Workers' Compensation Questions & Answers
1 Answer | Asked in Employment Law, Workers' Compensation, Medical Malpractice and Small Claims for Texas on
Q: Can I do something about all this things that are going on with this doctor? not all details were included.

My employer is a specialist that performs oral surgeries. Her assistants are phlebotomist and not surgical assistants nor dental assistants, but they are next to her doing surgery with very minimal to no training. She has them taking x-rays without a license. She also leaves out of town and the... View More

S. Michael Graham
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S. Michael Graham
answered on Mar 29, 2018

These are potential violations of the law which need to be addressed by the appropriate agencies like the state medical board, health department, OSHA, or district attorney's office. These violations do not fall under workers' comp which deals primarily with injured workers.

1 Answer | Asked in Workers' Compensation for Texas on
Q: My husband WC claim was denied after receiving payment for 8 wks due to a medical statement being incorrect. What to do?

The admitting physical was contact and confirm that the statement was wrong and offer to do what was need to get this corrected. We did start the appeal process. My question is should we contact the WC claim adjuster and let the physician speak with them confirm the incorrect diction of the medical... View More

S. Michael Graham
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S. Michael Graham
answered on Mar 28, 2018

Unfortunately, the adjuster is not on your side. My advice is to contact a workers' comp attorney. It sounds like you are in for a fight. If you can get the ER doctor to write an amendment or correction to his notes then that would be very very important to try to get that done. The judge will... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: What happens if workers comp is wanting me to go back to work when i feel i'm physically unable.

It has been 3 years already and i have goen through temporary benefits and received an mmi of 60% and still collecting those benefits. I still have at least 3 surrgeries to go until i'm done. What can they do if i refuse to do restricted work at a sandwhich shop, probably the only thing i... View More

S. Michael Graham
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S. Michael Graham
answered on Mar 26, 2018

You probably would be best advised to contact a workers' comp lawyer on the phone. It sounds like you are entering supplemental income benefits phase of your case. There are many legal rights and responsibilities that you need to be thoroughly familiar with in order to obtain these benefits.

1 Answer | Asked in Workers' Compensation for Texas on
Q: I just had my mmi and ir. I refused surgery, so the Dr said he would use my last measurements, is this backdating?

Will this hurt my chances of getting compensated? He said my hand and shoulder hasn't gotten better. I had surgery on my hand a year ago and it didn't go well...my reasoning for not wanting surgery on my shoulder. So he said he would probably use the same measurements from the previous mmi.

S. Michael Graham
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S. Michael Graham
answered on Mar 26, 2018

I would think the doctor would take new measurements unless you are past your statutory MMI date. You are not required to have surgery. That is a personal decision. If you do not receive additional treatment, then the doctor will often use a date occurring before your visit with the doctor (back... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I have an attorney who does not return my calls or emails. I am on workers comp & cannot get the help I need. I'm now on

Medicare & having to use my personal insurance to get help. Workers comp is not helping me or paying an of my bills

S. Michael Graham
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S. Michael Graham
answered on Mar 23, 2018

An attorney should respond to you within a reasonable amount of time. If your attorney will not respond to you, you can file a DWC 150A form to release your attorney from representing you. You can then possibly seek new representation if that is what you want.

1 Answer | Asked in Workers' Compensation for Texas on
Q: My husband was severely burned at work (2nd degree to hand/wrist/forearm and neck). No impairment rating assigned?

My husband was severely burned at work (2nd degree to hand/wrist/forearm and neck). He returned to work after being out 2.5 months (10 weeks). He received 70% pay while out and medical expenses paid, but no impairment rating when returning to work. Is this the end? Will no more impairment... View More

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

My office can help to ensure that your husband receives a rating for his injury. We also work with medical professionals can can help to review the ratings to make sure they are fair and correct. We often have to challenge ratings before the administrative law judge.

When you get a chance,...
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1 Answer | Asked in Workers' Compensation for Texas on
Q: I received notice of disputed issue and refusal to pay benefits. What is the time frame I have to respond ?
S. Michael Graham
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S. Michael Graham
answered on Feb 26, 2018

I would need more information to know exactly what they are disputing. Is it your whole claim? Is it the extent of injury? Is it the impairment rating? Depending on what has been disputed, you will be subject to different time frames. My advice is to contact a workers' comp attorney on the... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I was injured 5 months ago and I'm still on wc injury was a 18 wheeler ran over my right foot broke my ankle, all bones

And had to have a skin graft that's is half of my lower leg Dr says he's releasing me to light duty work but with my job that includes standing at hours end and I can barely stand for an he without pain I'm worried that I'll never be able to do my occupation ever again and do... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 19, 2018

If you are unable to stand and you have not been placed at maximum medical improvement for your injuries, then you can be paid while you are recovering from your injuries. You should also be entitled to a permanent disability rating. I'm not too sure if it would qualify for the skin graft... View More

1 Answer | Asked in Estate Planning, Family Law, Tax Law, Workers' Compensation and Social Security for Texas on
Q: Does arears child support payments affect an adult disabled child's social security income?

I have a severe and profound intellectually disabled child who is 20 years old. She has no income and I her amount of ssi income is around 30.00 per month. I was told, because her father was now paying his arrears child support, it had to be counted as her income. Her arears child support was... View More

Terry Lynn Garrett
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Terry Lynn Garrett
answered on Feb 16, 2018

Yes. Ask the court to enter an order that it must be paid into a special needs trust, an account with a master pooled special needs trust (such as the ARC of Texas Master Pooled Trust) or a combination of these with an ABLE account on which you have signatory authority (see www.stable.org). Money... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I been getting Workman comp and if I Lea ave the job and go to another will I still get Workman comp
S. Michael Graham
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S. Michael Graham
answered on Feb 14, 2018

If you quit, you will not loose your workers' compensation benefits for that reason.

1 Answer | Asked in Workers' Compensation for Texas on
Q: WHAT IS THE TIMELINE FOR A CLAIMS ADJUSTER TO APPROVE MEDICAL SERVICES ON A WORKERS COMP CLAIM?

SOME HAVE SAID THEY HAVE TO APPROVE SERVICES WITHIN 72 HOURS, THIS IS FOR DURABLE MEDICAL EQUIPMENT (DME)

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 14, 2018

The approval is authorized by the utilization review company that the Carrier subcontracts with. For Emergency there is no time line. For some emergencies it will be 72 hrs. For general denials it will be 3 or 7 days to respond to the request. Some DME less than $500.00 I believe doesn't... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: How many times can the Ins. company make me go back for a MMI/IR ??

I went in and got my MMI/IR from the Dr. the Ins.company sent me to, about 6 weeks ago. He gave me a 15% IR. Now the Ins. company is sending me to another Dr. for the same thing. Seems like they are trying to get a lower IR..??

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 13, 2018

You are correct. The carrier is trying to make you get a lower rating. You will likely need to fight this out at a DWC contested case hearing. My advice is to contact an attorney to represent you. There is potentially a huge difference in income benefits from a 14% and 15%. The reason is because a... View More

1 Answer | Asked in Personal Injury, Workers' Compensation and Trademark for Texas on
Q: My husband broke his hip working for a company over 20 years ago they had amerisure and it was done thru workmans comp

Company dosent have amerisure any more and needs a workman's comp claim number .how do I go about getting that it was 20 years ago

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

You can contact the Texas Department of Insurance, Division of Workers' Compensation. Your husband will need to provide his name and SS# and date of injury. They should be able to provide you with the information you need. You can also google the Insurance Company to see if they can tract the... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Filed work comp claim as occupational disease. My work comp doctor read my MRI results told me I need surgery

Surgeon told me need surgery to repair high grade tear in radial collateral ligament, repair partial tear in common extensor tendon. surgery denied. Sent for 2nd opinion. Surgeon highly recommends surgery, lateral epicondylitis and collateral ligament injury. My surgeon asked if 2nd surgeon said... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Feb 6, 2018

I'm not a medical doctor. I would generally state that you should follow your doctor's advice. If you don't trust your doctor's opinion, you might need a new doctor. I don't know if the insurance company accepted your tendon tear and your epicondylitis? You should ask the... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Are doctors' excuses not valid for getting paid, or must it be on a Form 73?

When I first received my workers compensation packet from the adjuster at my work, it stated nothing about having Form 73 being filled to receive payment as being out. My doctor has been filling out Form 73s and sending them to the adjuster, I have been bringing doctors' excuses for the days... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 31, 2018

You must be able to prove to an administrative law judge that you were unable to obtain or retain your preinjury wages due to your compensable injury. The adjuster can either pay or not pay you depending on what she thinks this personally means to him/her. There is no magic requirement to have... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I’ve reached MMI my doctor released me with the restriction of sedentary work. I just got IR of 8% is that low ?

I fell down a ladder at work,long story short my doctors encounter all this with my knee.

Derangement of Knee

Deficiency of Anterior Cruciate Ligament

Current Tear of Medial Cartilage

Patellar Tendonitis

Knee Joint Effusion

Tear of Medial... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 31, 2018

The rating seems about right for the injuries that you sustained. You do have the right to get a post designated doctor impairment rating. You can see if the post DD rating comes out to be the same. If there is a substantial difference, you might want to challenge the first rating you received. You... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Broke wristand ankle on the job with no safty equipment was issued.

Was knocked off of ladder by fellow emplyee. Broke my right wrist wich was opperated on and plate installed and broke right ankle calcanious fracture. After a year still very painfull and some days cant even walk. Only gave me 9% impairment. What about mental and physical anguish plus the pain and... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 30, 2018

If your employer purchases a policy of workers' compensation, then you are barred from suing the employer for negligence unless there is death and gross negligence involved. This is the main reason employers choose to purchase workers' compensation. That is, so they will not get sued when... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Workers comp disputing my impairment rating from 15%, knocked it down to 10%.

I received a 15% IR from the doctor workers comp sent me to. My case worker sent me a letter stating they will pay a " more reasonable " 10% impairment. Is this common practice for workers comp to do this? I went to their doctor for my rating and they knock the IR down. Will I lose... View More

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 29, 2018

The insurance Carrier does have the right to make a legal challenge to your 15% rating. However, you have some bullets to fight back with. You have the 15% rating. You can also obtain an alternate impairment rating from another doctor. You will almost certainly have to attend a Contested Case... View More

1 Answer | Asked in Employment Law and Workers' Compensation for Texas on
Q: My daughter injured her shoulder and neck in two separate incidents at the school she works at.

The WC people at her school will not approve an MRI or treatment by an orthopedic doctor.

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 22, 2018

If your daughter works as a public school in Texas, she will be covered by workers' compensation. If she works for a private institution, there may or may not be workers compensation coverage. If she is covered by the Texas Department of Insurance, Division of Workers' compensation, she... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: I got injured at work. Dr said I can go back, but I'll make it worse

I have trigger finger from typing. I went to ortho yesterday and scheduled MRI. The only restriction he listed was no lifting. I'm worried about losing workers comp for medical bills if I refuse. Can my company fire me? My boss said I have to go to work since trays what Dr is saying.

S. Michael Graham
PREMIUM
S. Michael Graham
answered on Jan 18, 2018

The general rule is that you must go back to work if your employer can accomodate your work restrictions. You don't have to go back to work, but neither your employer or the wc Carrier will owe your any wages or wage substitution (TIBs). You should really discuss this matter with a qualified... View More

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