How to Get More Money From A Texas Workers Comp Case

Increasing Your Temporary Income Benefits (TIBS)

Your Temporary Income Benefits (TIBS) are what most people refer to as a “comp check.”  These are the checks that you receive for up to 104 weeks when unable to work.  Insurance companies often figure these Comp Checks too low or in their favor.  Does this surprise you?  Call us and see if your Comp check is too low.  Your weekly check is supposed to be calculated on 13 weeks of wages before your date of accident, including overtime and any job benefits that have stopped.  If you worked less than 40 hours during any of these 13 weeks, we may be able to exclude those weeks.  If you were employed for less than 13 weeks, your Comp check should be calculated on a "same or similar" employee working for at least 13 weeks, using his pay and benefits.

Increase Your Impairment Income Benefits (IIBS)

Impairment Income Benefits (IIBS) start if you receive an impairment rating.  When IIBS start TIBS permanently stop.  IIBS benefits are less than TIBS and you should never rush into getting an impairment rating because you will cut your comp check, sometimes significantly.  However, the most important thing is to make sure that your TIBS check is the correct amount and that you are not being underpaid for Temporary Income Benefits.  Once your average weekly wage is established it will be used for TIBS benefits, IIBS benefits and SIBS benefits.  Your treating doctor is very important in establishing your impairment rating, and if you make a bad choice of treating doctors, you will suffer in loss of income due to a low impairment rating and from inadequate medical care.  Sometimes it’s the injured workers that make the mistake of choosing the wrong doctor out of ignorance or loyalty to a family doctor.  It is always a mistake to go to a doctor for a workers comp injury without consulting a workers compensation lawyer.

Increase Your Supplemental Income Benefits (SIBS)

Supplemental Income Benefits (SIBS) are paid to injured workers whose impairment rating is at least 15%.  Here again, it is of utmost importance to get help in choosing your doctor for a workers compensation injury.  Supplemental Income Benefits can be paid up to 401 weeks and this usually involves more comp payments.

Collect Unpaid and Underpaid Comp (TIBS, IIBS & SIBS)

If your Texas Workers Compensation Check is less than the maximum rate, there’s always a chance you are being underpaid by the Workers Comp Insurance Carrier.  How could this happen?  First of all, your employer must furnish correct wage information to the insurance carrier and calculate your average weekly wage based on a Texas Department of Insurance, Workers Compensation Division formula.  It’s very complicated and in our experience they seem to almost always make a mistake in their favor and not in the workers’ favor.  We will leave the conclusion of this to you.  Call us and we will calculate what you should be receiving, right over the phone, in just a few minutes. This is free and there is no obligation at all.  We will even do this for you anonymously.


Original source: http://www.workerscomp.com/how-to-get-more-money-from-a-texas-workers-comp-case/

Protect yourself in Workers Compensation Cases

It is extremely important that you protect yourself from the insurance carrier and insurance carrier doctors when you file for workers’ compensation.  Once you report an injury to your employer, your employer should notify its workers’ compensation insurance carrier.  A representative from the insurance company, called an Adjuster, will contact you to get information from you regarding your injury.  Usually they will want to take a recorded statement.  This is when the Adjuster asks you questions regarding the injury and records your conversation over the phone.  You should not give a recorded statement without first consulting a workers’ compensation attorney. An attorney at Abbott & Associates will go over your claim with you in detail prior to you speaking with an adjuster.

We will make sure you are fully prepared to answer questions regarding your injury and all other questions that Adjusters commonly asks when conducting a recorded statement.  The insurance carrier uses a recorded statement against an injured worker to catch them in a misstatement.
For example, if asked about your work incident and injuries and you do not mention every single body parts you injure or if you leave out a specific detail regarding how you injured yourself or a past injury you sustained, the carrier will use it against you in your claim to state you were not being truthful and trying to hide an important fact or lie about it.  This comes into play when you go before a Judge. If any part of the claim is being disputed and calls into question your credibility, any misstatement or error from your recorded statement will be used against you.

Further, the Adjuster will try to discuss with you options about choosing a doctor.  Many times adjusters will want to send you to their doctors that they know to perform a cursory examination; maybe perform an x-ray (which only evaluate broken bones not soft tissue, ligament, or spinal cord injuries, which are seen using a MRI) and try to return you back to work immediately without any additional testing or examinations.

Our firm will protect you and make sure you choose to treat with a doctor that has your best interest at heart and wants to help you with your injuries, not just send you back to work as soon as possible without providing the proper treatment to save the insurance carrier money.  The Adjuster will also try to assign a nurse case manager to handle your claim.  You should not let a nurse case manager choose a doctor for you or attend any appointments with you.

The nurse case manager is an employee of the insurance carrier who is hired to assist in getting you in and out of treatment as quickly as possible to end your case.  They try to push the doctors to release you back to work even if you are not capable or ready to go back. Our firm will communicate with the nurse case manager to get the necessary treatment approved by the carrier and limit communication between the nurse case manager and the doctor.  

Finally, at the beginning of a claim you are mailed a medical release authorization from the insurance carrier to sign and return.  This authorization will allow the Carrier to get a copy of all of your medical records from any doctor you have ever treated with, not just for the current workers’ compensation injury.  You absolutely want to consult with an attorney at our firm prior to signing this or any other document to release information to the carrier.  
Original source: http://www.workerscomp.com/protect-yourself/

Texas Workers’ Compensation Injuries – Are You Being Watched?

As an injured worker you may think to yourself, why in the world would someone follow me? Well the insurance company wants to try and catch you doing something beyond your restrictions so that they can cut off your benefits.

Many times the investigators record injured workers unloading groceries; and although those groceries may just be bread loafs and eggs, the insurance adjuster will try to say that the injured worker's ability to unload groceries shows that his back injury is not severe.

The injured worker knows the groceries were not heavy, but that will not stop the insurance company from stopping the benefits.

If you have been injured on the job do not wait until your benefits are cut off, contact a worker's comp attorney and go over what rights you have under the Texas Worker's Compensation Act.

As long as an injured worker is not doing anything beyond the restrictions their doctor gave them there should be no basis for the insurance company to cut off benefits, and as such an experienced worker's comp attorney can communicate with the insurance company and fight to continue an injured worker's benefits.

If the insurance carrier continues to dispute an injured worker's right to benefit the attorney can file a request for a hearing so that a mediator can try to facilitate a resolution.

If no resolution is possible then the case will get set for a trial and the attorney can present the case to a judge and show how despite the investigator's surveillance video the injured worker is owed benefits.

Original source: http://www.workerscomp.com/texas-workers-compensation-injuries-are-you-being-watched/