There are some things that are very important that you do. Not doing any of these could ruin your case.
1. Immediately tell your supervisor or employer
The law says that you must tell your employer within 30 days of the date you were injured.
2. Fill out a Notice of Injury Claim Form
Send it to the Workers’ Compensation Commission within one (1) year of the injury. When you hire us, we can help you with this.
3. Keep all of your doctor appointments
Tell your doctor how you were injured. And tell your doctor if you believe it is work related. Tell your doctor about all of your physical complaints. For example, if your neck, back, and leg hurt, don’t just mention your neck and back and leave out the problem with your leg. Include everything.
Now lets talk about the money benefits provided for under the Law.
Lets say there is a dispute between you and the Insurance Company on your case.
If the Insurance Adjuster does not budge, you must enter the Hearing Process. So long as we are your attorneys, we will represent you at those Hearings.
1. The first hearing is called a Benefit Review Conference (BRC)
2. The second hearing is called a Contested Case Hearing (CCH)
Do you find all of this somewhat confusing?
Well, you’re not alone. You have now entered the land called Texas Workers’ Compensation Law. Note that it is not called the Texas “Fair” Compensation Law. The word “fair” appears nowhere in this law.
We understand that this can be very confusing and you may think you can’t get anywhere with it, but that is why you are here. Our office has handled thousands of these cases. We do understand them and we can help you, step by step, get the most you can possibly get for yourself and your family without you having to understand all the legalities and without you having to deal with the insurance company.
So let’s work together as a team and move forward.
1. Immediately tell your supervisor or employer
The law says that you must tell your employer within 30 days of the date you were injured.
2. Fill out a Notice of Injury Claim Form
Send it to the Workers’ Compensation Commission within one (1) year of the injury. When you hire us, we can help you with this.
3. Keep all of your doctor appointments
Tell your doctor how you were injured. And tell your doctor if you believe it is work related. Tell your doctor about all of your physical complaints. For example, if your neck, back, and leg hurt, don’t just mention your neck and back and leave out the problem with your leg. Include everything.
Now lets talk about the money benefits provided for under the Law.
- Workers hurt on the job first receive weekly checks when they cannot work. These are referred to as TIB’s (Temporary Income Benefits). The benefits will be paid until the disabled worker is certified to have reached MMI (Maximum Medical Improvement).
- After the worker reaches MMI, he/she may be entitled to Impairment Income Benefits (IIB’s). If the doctor determines that the worker has a permanent impairment rating using the AMA guidelines, the worker is entitled to three weeks of benefits for every percent point of impairment given. So, for example, if the worker is assessed 3% Impairment, he/she would receive nine weeks of IIB’s.
- It is not unusual for the workers’ doctor to give a higher percentage, and the insurance doctor a lower percentage. In this case the Texas Workers’ Compensation Commission will approve a Designated Doctor to determine the proper percentage.
- After IIB’s runs out, the worker may be entitled to additional checks if the worker has received fifteen percent or greater impairment. These checks are referred to as SIB’s (Supplemental Income Benefits). Remember, the key to receiving these benefits is an Impairment Rating of 15% or greater.
- Two benefits, which seldom come into play, are Lifetime Benefits and Death Benefits.
- A worker who suffers a catastrophic injury while on the job may be eligible for Lifetime Benefits, while the legal beneficiaries of someone killed on the job may be eligible for death Benefits. If you wish, our office can provide you with more information on these benefits.
Lets say there is a dispute between you and the Insurance Company on your case.
If the Insurance Adjuster does not budge, you must enter the Hearing Process. So long as we are your attorneys, we will represent you at those Hearings.
1. The first hearing is called a Benefit Review Conference (BRC)
- This is an informed proceeding conducted by Benefit Review Officer. Present is the Insurance Company Representative, either an attorney or adjuster, you and your attorney.
- The goal is to resolve the dispute. If this cannot be done, the Benefit Review Officer makes a recommendation and the case proceeds further to the second hearing.
2. The second hearing is called a Contested Case Hearing (CCH)
- This is an Administrative Trial, complete with a Hearing Officer, evidence, witnesses and lawyers. The Hearing Officers receive direct and cross-examination testimony as well as other evidence from witnesses. After the record closes, the hearing officer renders a written decision. This officer’s award is final unless the decision is appealed.
- The Decision of the Hearing Officer at the CCH can be appealed to the Appeals Panel and that decision can ultimately be appealed to District Court. As this is a Trial de Novo, the proceedings start anew.
Do you find all of this somewhat confusing?
Well, you’re not alone. You have now entered the land called Texas Workers’ Compensation Law. Note that it is not called the Texas “Fair” Compensation Law. The word “fair” appears nowhere in this law.
We understand that this can be very confusing and you may think you can’t get anywhere with it, but that is why you are here. Our office has handled thousands of these cases. We do understand them and we can help you, step by step, get the most you can possibly get for yourself and your family without you having to understand all the legalities and without you having to deal with the insurance company.
So let’s work together as a team and move forward.
