How to Dispute the Insurance Carrier’s Decision in a Texas Workers’ Comp Case?

“An injured worker is entitled to apply for workers’ compensation benefits in the state of Texas if the workers’ employer is a participant in the workers’ comp benefits program.”

An injured worker is entitled to apply for workers’ compensation benefits in the state of Texas if the workers’ employer is a participant in the workers’ comp benefits program. Workers’ compensation is a state-regulated insurance program, which means that there are strict rules regarding worker rights. There are also rules regarding the benefits available to an employee who has suffered a work injury or become sick due to work tasks.

When an employee is not happy with the decision made by the workers’ comp insurance carrier, there is an appeals process that can be followed. Employees may get help resolving any type of dispute related to workers’ compensation benefits. The Texas Department of Insurance Division of Workers’ Compensation helps to facilitate dispute resolution. Therefore, if an injured worker is not happy with decisions made by the insurance carrier, it is possible to seek relief by going through the dispute resolution process of the Division of Workers’ Compensation.

An experienced Houston, TX workers’ compensation lawyer can assist with every phase of the appeals process in order to help workers get the benefits that they need and deserve. If the insurance carrier has denied workers’ compensation benefits to which you are entitled, contact an experienced attorney today.

WHAT TO DO IF YOU ARE NOT SATISFIED WITH THE INITIAL DETERMINATION OF YOUR WORKERS’ COMP CASE
There are actually several different stages of review that are part of the dispute resolution process when you and the employer’s insurer disagree about either your eligibility for workers’ comp benefits or about the types of benefits that you should be receiving.

For example, when a dispute arises, you can ask for a benefit review conference (BRC). A BRC is held at a Division of Workers’ Compensation Office and the conference is presided over by a Benefit Review Officer who works for the Texas Department of Insurance. The meeting is an informal one attended by you and the insurance company to give you an opportunity to come to a resolution of a disagreement. A BRC can resolve a wide variety of different issues, including disputes over medical fees.

After this BRC, if disagreements about benefits remain, you can choose to resolve the ongoing disagreements by having your case heard at a Contested Case Hearing (CCH) is held after a BRC. This is a more formal hearing than the BRC. A Hearing Officer from the Division of Workers’ Compensation presides over the hearing and is asked to make a decision on any disputed issues not resolved at the BRC. You are notified of the decision later in writing after the Contested Case Hearing.

If you are dissatisfied with the decision that was made by the hearing officer, the next step is to ask the appeals panel to review the prior decisions that were made. You do not have to attend another hearing before the appeals panel, which is still a part of the Division of Workers’ Compensation. Instead, written arguments are submitted explaining your position about why the prior decisions were wrong.

The Appeals Panel will review the written arguments, the record from the Contested Case Hearing, and the written decision made by the hearing officer. If it determines that there were errors made in the handling of your case and the decision made on the disputed issues, then you may get a different outcome to your case than what the hearing officer had chosen. A written decision will be issued by the Appeals panel explaining the outcome of your appeal. This is the last phase of appeals that is handled internally by the Division of Workers’ Compensation.

If you are still not satisfied with what the workers’ comp board has done, you can request judicial review. This takes the case out of the purview of the Division of Workers’ Compensation for the first time and it puts it before a judge. The judge does not just substitute his or her own opinions about the case- the judge will look at what was done before and will consider whether any errors were made that had an adverse impact on the outcome of your case.

It is important to have legal representation throughout the appeals process, as it can be very complicated to get decisions by the workers’ comp board overturned. An experienced attorney can help you throughout the process so you can protect your rights.

Abbott & Associates, LLC, is a Plaintiff Personal Injury Law Firm in Houston, offering services for workers' compensation matters throughout Texas.

They do not represent companies or insurance carriers. The primary focus is on Workers’ Compensation claims and maritime injuries. They represent injured works before every field office in the state of Texas and have handled more Workers’ Compensation claims than any other plaintiff Firm in the state. Firm handles the largest volume of Workers Compensation claims for injured workers in the state.

Abbott & Associates, LLC - 12600 N Featherwood Drive Suite 200, Houston, TX 77034

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Original Source: https://www.slideshare.net/AbbottClayReed/how-to-dispute-the-insurance-carriers-decision-in-a-texas-workers-comp-case

Job Security after A Texas Workers Comp Injury

Job security is an issue for everyone, but after you have suffered an injury at work then protecting your job becomes even more important. Your employer and workers’ compensation insurer may have an incentive to try to force you to go back to work before you are ready in order to reduce the benefits they are paying you. Your employer may even be looking for reasons to fire you so that your disability benefits can stop.

It is important that you know your rights and protect yourself so you do not lose your livelihood and the workers’ compensation benefits you depend upon. One of the best ways to ensure that you do not lose your job because of your work injury is to have a lawyer in your corner.

How to get Security in Protecting Job, after a Workers Comp Injury
After a work injury, you should receive wage loss benefits if you are not able to return to work for a period of time. Your employer cannot fire you for making a workers’ compensation claim or for being unable to come in to work as a result of your illness or injury.

Unfortunately, sometimes a doctor- especially one chosen by your employer- will release you to return to work before you are actually ready to resume job tasks. If this happens and you are not productive or effective at your job, your employer may try to build up reasons to fire you for cause.  If you are being pressured to go back to work when you don’t feel right, you need to get a Texas workers compensation lawyer to assist you so you don’t end up being forced to do a job you cannot do.

In some cases, your doctor may say that you can do some work but that you will be on restricted duty or light duty. When you are cleared to work, but with restrictions, your employer has the option but not obligation to offer you a job you can do with your limitations. If your employer offers you work, your benefits will be reduced based on what the job pays. This is true regardless of whether you actually accept the work or not.  When the wages on this light duty job are lower, you should receive partial lost wages benefits to make up a portion of the difference between pre and post injury wages.

However, if you go back to work on light duty, your employer may not respect the restrictions your doctor has imposed on you- which can affect your ability to do your work. This is another situation where, having a Texas workers’ compensation lawyer becomes very important for your job security as well as for your health.

Abbott & Associates L.L.C. is widely regarded as having a tough reputation for fighting for our clients. We can fight to ensure your employer does not take away your job security because you happened to get hurt or sick due to your work.

Original source: http://www.workerscomp.com/job-security-houston-tx/

Texas Workers Comp Benefits for Injured Workers

There are a variety of different types of compensation benefits available to you after a workplace injury. If you can show you are sick or hurt because of your job, you should receive:

•    Medical coverage. All necessary medical treatment to treat your workplace injury or illness should be covered. You may also be able to secure coverage for adaptive medical devices, nursing care, and transportation to medical appointments.
•    Income benefits. If your injury has reduced earning ability or has caused you to be unable to work, you should receive temporary or ongoing compensation benefits to provide for yourself and your family. Your income benefits may be based on your average weekly wages before you got hurt, as well as your level of impairment, depending upon the type of benefits you are receiving.

In the event that a worker is killed on the job, his or her surviving family members will also receive compensation benefits. These benefits include:

•    Burial expenses: Workers’ compensation should provide coverage for at least a portion of the deceased’s funeral and burial.
•    Death benefits: Death benefits cover a part of the income that the deceased is no longer able to contribute to the family due to his untimely death.

These compensation benefits should be available as long as your employer purchased workers’ compensation insurance and as long as you can show that the injury or death is due to your job. You can recover compensation benefits both after an accident and if you were exposed to chemicals or toxins that made you sick. You may also receive compensation benefits for things like repetitive stress injuries and accidents off-site. Abbott & Associates LLC will help you to prove you are entitled to compensation benefits if you have a covered workplace injury or illness.

Getting Legal Help – Texas Workers Comp Benefits

Compensation benefits are supposed to provide for you and ensure you do not face financial problems due to getting hurt because of work.  Unfortunately, you may have a legitimate claim for benefits denied or the workers’ compensation insurer may try to deny you some of the benefits you deserve. Call today to speak with Houston, TX work injury lawyer who will do everything possible to help you get the benefits you deserve.

Original source: http://www.workerscomp.com/comp-benefits-houston-tx/