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Your Injury, Your Choice: Pursuing a Workers’ Compensation Claim on Your Own Terms (Mostly)


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10/5/2016
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When you’ve suffered an injury at work it’s difficult to know what to do, where to turn, and how to cope. You’re in pain. Your employer seems to lack compassion for the situation, and the insurance company treats you as a nuisance. Your frustration builds.

Texas law requires that most employers purchase workers’ compensation insurance on behalf of injured employees. However, to avoid being taken advantage of, or allowing your employer to disregard your pain and suffering, you have to take an active role in protecting your workers’ compensation rights. Specifically, you have choices to make in two key areas:

  1. When to get treatment.
  2. The health care provider who will treat you.

Your Choice in Timeframe to Secure Treatment and Claim Success

It makes sense to seek medical care immediately following a workplace injury. In addition to protecting your own wellbeing, seeking prompt care assures your employer that your injury was, indeed, work-related and serious.

If you delay seeking medical care, you put your claim in jeopardy. When injured at work, many people decide to forego immediate treatment and attempt to “walk it off” or wait until the injury worsens before seeing a physician. The trouble with this is that it allows employers to question where, when, and how the injury occurred. Consequently, when the injury results in time off or a leave of absence, the employer may not be quick to approve workers’ compensation. However, by taking the initiative and seeking medical attention immediately following the injury you can provide essential evidence for your claim, including:

  • A paper trail that clearly links your injuries to the specific event at work.
  • A connection between the work-injury report you filed and your visit to the doctor.
  • A professional record of the injuries from the beginning, as well as a detailed record of their progression.

You may feel silly or overdramatic if you go to the doctor after a simple incident at work. However, you’ll most assuredly feel sillier if you fail to take action and are later denied compensation as a result. Report your injuries and seek treatment immediately, and time will truly be on your side. Otherwise, the more time that passes between the injury and a medical visit, the wider the door is for your opposition (in this case, your employer or your employer’s insurance company) to find fault with your claim.

Your Choice of Doctor

In Texas, you are entitled to choose your own doctor following a workplace injury. However, your employer does have a say in what type of medical care network classification he supports. Therefore, rather than choosing any doctor from anywhere, you may be required to choose a doctor within certain categories. The classifications that employers can elect for their employees are chosen from one of three categories— in-network, out-of-network, or non-network.

  • In-Network. If your employer has elected to use an in-network form of workers’ compensation, the doctor you choose must be approved as part of your employer’s specific network. Your supervisor can provide you with a list of treating physicians from which you may choose.
  • Out-of-Network. If your employer uses an in-network classification but you need a particular specialist that isn’t listed in his network, you have the right to request approval for an out-of-network referral. However, the initial diagnosis and referral must come from the in-network physician.
  • Non-Network. If your employer has elected not to use a network, you may choose a physician on the Division of Workers’ Compensation’s (DWC) Approved Doctor List (ADL). Every board-certified doctor in Texas is automatically added to the ADL. However, if a physician violates statutes and rules governing workers’ compensation, the Texas Workers’ Compensation Commission can remove him or her from the list. An index of doctors who have been removed from the ADL and are not permitted to treat Texas workers’ compensation patients can be found on the Texas Department of Insurance website.

Choosing a physician to oversee your treatment after a work injury is a very important step, so try to decide wisely. You should find a doctor who you feel has your best interests (not your employer’s) at heart. Much like your choice of attorney, he should also have a good amount of professional experience and bedside manner.

Choice in Legal Representation

To protect yourself, your rights, and your financial future following a workplace accident you must understand the detailed rules for workers’ compensation. Unfortunately, not many people are well-versed in the intricacies of Texas legislation—and this “lack of knowledge” is exactly what your employer depends on to deny you your rightful benefits. However, there is a loophole. As long as you know someone who has the necessary knowledge, skills, and experience in workers’ compensation law, you don’t need to memorize laws or argue your claim—we will.

Contact our office today to schedule your FREE consultation with attorney Steve Lee. A simple phone call to 713-921-4171 or completed contact form is all you need to see how he can help you gather the evidence you require, the treatment you deserve, and the knowledge you need to pursue your workers’ compensation claim successfully.



Category: Construction, Refinery, Industrial, On the Job Injuries and Workers' Comp

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