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Texas Workers' Compensation Questions & Answers
1 Answer | Asked in Workers' Compensation for Texas on
Q: I lost my workers comp case in TX 5 yrs ago. Pain is 1000% worse now. Can I re-open claim?

The carrier claimed my lower back injury was pre-existing & ironically, judge said not enough evidence to show it was an aggravation of prior injury. I have been to 5 physical therapists, chiropractors, ortho doctors & pain is far worse. If this was the simple “strain” the court made it... View More

John Michael Frick
John Michael Frick
answered on Jun 20, 2023

Probably not.

Many people develop back problems like degenerative disc disease with age.

Many people remain unaware and without symptoms until they suffer a relatively minor back injury like a sprain.

Once they become aware of the problem, they become very attuned to the...
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1 Answer | Asked in Employment Law and Workers' Compensation for Texas on
Q: Coworker cause my accident and we're both employed at the same place I cannot sue them for negligence can I

I was injured on the job February 9th 2021 by my production manager turned up the machine and it sucked me in and how's the bad accident to me 18% impairment rating but I'm being told that I cannot sue the company because we were both employed there and since workman's comps paying... View More

John Michael Frick
John Michael Frick
answered on Apr 23, 2023

Under workers compensation laws, a worker who is injured on-the-job is not required to establish that his employer or a co-worker was negligent in order to receive compensation for medical expenses and lost income. In exchange, the employer is not subject to a personal injury lawsuit by the... View More

1 Answer | Asked in Employment Law and Workers' Compensation for Texas on
Q: I recently got hurt at work I'm on light duty at the moment. Is my position protected?

They moved me to a different department I was told temporarily while being on light duty. But just two days ago one of the coaches acted as if he is switching me permanently. Which means I get to pay decrease and lose my position I had all do to be hurt. I work at Walmart is this allowed

S. Michael Graham
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S. Michael Graham
answered on Mar 13, 2023

If your claim is in Texas, Walmart no longer carries workers' compensation through the Texas Department of Insurance, Division of Workers' compensation. They are nonsubscribers to workers' comp. Walmart has it's own private insurance. I believe your employer can permanently... View More

1 Answer | Asked in Workers' Compensation and Social Security for Texas on
Q: Can my w.c. case be closed because my pain doctor, who I have seen for 18 years, used the wrong compensable injury on

the claims sent to my adjuster? Without my knowledge, my doctor started filing on my medicare when W.C. stopped paying him, almost 2 years ago. I called my adjuster & she said if he had listed the correct compensable injuries (L. foot (CRPS), Neck, Rt. shoulder) he would have been paid. Today I... View More

James L. Arrasmith
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answered on Mar 4, 2023

It is possible that your workers' compensation case could be closed if the wrong compensable injury was used on the claims sent to your adjuster. However, this would typically require some sort of legal action, such as a hearing or settlement agreement, which would likely involve notification... View More

3 Answers | Asked in Workers' Compensation for Texas on
Q: My sister was injured at work. Workman’s Compensation is denying surgery despite the MRI findings of a torn rotator cuf

MRI shows torn rotator cuff in three tendons. What are her next steps. She lives in Texas and cannot afford to hire an attorney. Should she have surgery done under her private insurance?

Jimmy Doan
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Jimmy Doan
answered on Mar 5, 2023

Your sister is not alone in facing what appears to be an initial denial of her Texas worker’s compensation claim. Unfortunately, when it comes to Texas worker’s compensation cases, a significant percentage of claimants are denied when they initially file a claim for benefits.

A bit of...
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3 Answers | Asked in Workers' Compensation for Texas on
Q: My sister was injured at work. Workman’s Compensation is denying surgery despite the MRI findings of a torn rotator cuf

MRI shows torn rotator cuff in three tendons. What are her next steps. She lives in Texas and cannot afford to hire an attorney. Should she have surgery done under her private insurance?

John Michael Frick
John Michael Frick
answered on Feb 15, 2023

If her treating doctor is an orthopedic surgeon and is recommending surgery, he/she needs to request a peer-to-peer with the workmen’s compensation carrier’s orthopedic surgeon to discuss why surgery is the best option in her case.

Surgery is not always necessary or recommended for a...
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3 Answers | Asked in Workers' Compensation for Texas on
Q: My sister was injured at work. Workman’s Compensation is denying surgery despite the MRI findings of a torn rotator cuf

MRI shows torn rotator cuff in three tendons. What are her next steps. She lives in Texas and cannot afford to hire an attorney. Should she have surgery done under her private insurance?

Tim Rose
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answered on Feb 15, 2023

Sorry to hear she is having trouble. She likely CAN afford an attorney as most workers' compensation attorneys work on a commission basis - no fee until you win. I would suggest looking in the Justia directory for the area of Texas where she is and see if there is an attorney to consult with... View More

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1 Answer | Asked in Libel & Slander, Employment Law, Workers' Compensation and Civil Rights for Texas on
Q: Do you believe under any section on any category are black people seen as equally equal or separateed equally equal?

Honestly honest opinion

John Michael Frick
John Michael Frick
answered on Feb 13, 2023

Article 1, section 3a of the Texas Constitution provides: “ Equality under the law shall not be denied or abridged because of sex, race, color, creed, or national origin. This amendment is self-operative.”

In my professional experience, I have rarely seen individuals treated...
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1 Answer | Asked in Workers' Compensation for Texas on
Q: Do I still go to my dr? Why did the catscan show one thing but X-ray from company dr show different? Are they lying?

I was at work. Got hurt ambulance took me to ER. They did a catscan and said my nose was broke and return to regular duty after follow up with surgeon. My jobs safety talked to person doing paperwork and told them to put me on light duty so they changed it on the paper. The next day the hospital... View More

John Michael Frick
John Michael Frick
answered on Jan 16, 2023

CT scans are an advanced type of X-ray that shows blood vessels, organs, and other soft tissues well.

X-rays do a better job showing showing the skeletal structure including broken bones.

Different radiologists occasionally disagree on what the exact same test shows, and more...
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1 Answer | Asked in Workers' Compensation for Texas on
Q: Work Comp Peer Review says surgery, but they won't approve pre-auth for it. What do I do?

I work for a school district and fell on campus. Over time my injury was getting worse, even though I sought treatment that day and months after. TASB had a peer review done that agreed my injury was likely caused by a fall and that surgery was recommended. After working with my dr to remedy the... View More

S. Michael Graham
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S. Michael Graham
answered on Jan 3, 2023

The adjuster on your file does not have medical training so whether the surgery is reasonable and necessary is subcontracted out to medical specialist that determine whether the requested procedure meets ODG guidelines. If the LHL-009 (Request for IRO) is not successful, then I would recommend you... View More

1 Answer | Asked in Workers' Compensation, Business Law and Construction Law for Texas on
Q: Construction company in Texas. Waive of Liability for Subcontractor without Worker's Comp?

I am hiring a subcontractor - They do not have workers comp. Can I have them sign a release of liability?

John Michael Frick
John Michael Frick
answered on Jan 2, 2023

Yes, the TWCC has a specific form especially designed for this purpose.

1 Answer | Asked in Workers' Compensation for Texas on
Q: In Texas,on the job injury,must a ua be taken within 8 hours of the injury,for the rebuttable presumption ?
S. Michael Graham
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S. Michael Graham
answered on Nov 2, 2022

I am not aware of any 8 hour time frame. Usually, the further out the test is taken the more likely it is that you would be intoxicated. The drugs/alcohol will leave the system with time.

1 Answer | Asked in Workers' Compensation for Texas on
Q: How long after workmans comp submission can I sue if they gave me the run around. Say it approved but docs had nothing.

Got injured at work a few years ago and workmans said everything was approved I'd go to physical therapy/ pain management doc and they always said they hadn't received anything but yet had my name. The exception was the regular doctor that could only apologize say they had no idea what... View More

John Michael Frick
John Michael Frick
answered on Oct 20, 2022

You can’t sue.

But you can receive medical treatment for your work-related injury from any health care provider who accepts worker’s compensation cases.

Your health care provider will likely need your TWC case number for your workers compensation claim to bill the correct party.

1 Answer | Asked in Workers' Compensation, Health Care Law and Insurance Defense for Texas on
Q: If I return to full duty at work, is the responsibility of the insurance carrier over?

I injured my right knee during a slip and fall at work. The injuries are a complete tear of the ACL, partial tear of the MCL and buckling of the PCL. I have arthritis in me knee and the only surgery that me doctor will do is a complete knee replacement. The Worker’s Comp insurance carrier said... View More

S. Michael Graham
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S. Michael Graham
answered on Sep 15, 2022

It is very difficult to prove a total keen replacement is due to your work related injury. You will need an expert medical opinion to state all the conditions for which you need the total knee replacement are a result of the work injury within a reasonable medical probability. If you prove this,... View More

1 Answer | Asked in Personal Injury and Workers' Compensation for Texas on
Q: I was assault bye a shoplifter injuring hip and lower back

I was hurt on the job

Tim Akpinar
Tim Akpinar
answered on Aug 27, 2022

A Texas attorney could advise best, but your question remains open for two weeks. At this point, you could reach out to workers' comp attorneys to discuss your matter, since your injury took place in the course of employment. An experienced attorney should be able to outline any other causes... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: My workman’s comp Dr released me to go back to work but the regular Dr didn’t. What will happen if I returned to work?

Regular dr paperwork had a return to work date. I asked if I had any appointments the office said no. I went to see the workman’s comp Dr and he released me back to work per the notes from the regular Dr. I was back to work for 3 days. Started physical therapy and needed a refill on medication.... View More

Tim Rose
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answered on Aug 19, 2022

It is ultimately your decision whether to return to work and what is best for your health. Workers comp may decide not to pay you for the days you missed since their doctor has released you to work. You could also contact the work comp doctor and ask them to reconsider your work status based on the... View More

1 Answer | Asked in Employment Law and Workers' Compensation for Texas on
Q: I am currently going through wokers comp because of an injury at work. When my employer gave them my wage statement

For the last 13 weeks they put down 20 hours, 33 hours, 30 hours, 40 hours etc. I was actually working a ton of overtime. 60 hours, 60 hours, 58 hours, 48 hours, etc. there was only 1 week that I worked 38 hours and that was because I hurt myself on a Thursday and left early. The head... View More

S. Michael Graham
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S. Michael Graham
answered on Jul 6, 2022

If you have a claim filed through the Texas Department of Insurance, Division of Workers' Compensation, you have the right to challenge the wages your employer has listed at an administrative hearing. The easiest way is for you to get copies of your paycheck stubs to document your actual wages... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: If I’m ready to be released back to work and I feel my doctor is just dragging it out, can I demand to be released back?

I am ready to go back to work but i feel my doctor is dragging it out. Can I request to be released to go back to work or can the doctor refuse to release me?

T. Augustus Claus
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answered on Sep 29, 2023

Generally, a doctor has a professional responsibility to only release you to go back to work when it's medically appropriate. If you disagree with your doctor's assessment, you may seek a second opinion.

Q: ERISA502(A) My employer's Workmen's compensation plan is based on this part of the law, but they are not compliant.

They are not providing proper medical care

S. Michael Graham
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S. Michael Graham
answered on Aug 19, 2023

My law office doesn't handle ERISA claims. If your claim does not involve negligence on behalf of the employer or other third party, it is almost impossible to obtain legal representation. For this reason, the Carrier's offer little to no support. I like to refer to it as fake... View More

1 Answer | Asked in Workers' Compensation for Texas on
Q: Won CCH hearing. And was awarded benefits up until date of hearing. The insurance company appealing the decision.

Do I have to wait until the appeal panel decides or do I receive my benefits now

John Michael Frick
John Michael Frick
answered on Jun 14, 2023

If the benefits are TIBs, you should receive them promptly but they will be subject to clawback if the carrier wins your appeal from any future IIBs.

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