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My sister was hurt on the job July 2011. (severe broken leg

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My sister was hurt on the job July 2011. (severe broken leg which include metal rods and screws) She is still under doctor's care and was just fired from her job because she couldn't preform all the duties (because of the leg). She had received workers comp and the first impairment rating was 12%, however her subsequent rating is 14%, which she has been told may be denied. She now has no income and can't get unemployment because she isn't released from her Dr. to go back to full duty. Workman's comp said they aren't paying her anything else. What is she suppose to do?

Barbara McWilliams
Hi,

Thank you for your question.

Has she requested a hearing with the Texas Workforce Commissions regarding the insurance carrier's denial of benefits, the employer's termination, and the doctor's rating?

Does she have a workers' compensation attorney representing her?

If she has not been released by her doctor to go back to work full duty, then she is entitled to temporary income benefits until she finds another job which is within her restrictions placed on her by the doctor (i.e., light duty work). If the insurance company is denying these benefits, she needs to request a hearing the TWC to ask for an order that they immediately start paying these benefits.
Customer: replied 3 years ago.

She has a meeting scheduled for 11 Jul with the TWC. She is currently using an Ombudsman assigned to her and is the one who stated my sister was not authorized any additional monies from workers comp, as she receives the 36 weeks based on her 12% impairment rating. A meeting is scheduled the end of this month between my sister's former employer's (Aramark), workers comp insurance and her Ombudsman to determine if the insurance company will pay the additional 2%.(why wouldn't my sister attend) My sister disputed the 12% rating and that was when she was assigned an Ombudsman to assist her. She went to another workers comp doctor who after his exam increased her impairment rating to 14%. Her Ombudsman is the one that told her they normally go with the first rating, even though the doctor that did the second one is the one they call to court if it is contested again.


 


The workman's comp people have done nothing to help her. After one surgery we left the doctors to pick up her medication and the pharmacy couldn't give it to her because her workman's comp person didn't approve it right away - she had to go that whole evening with out pain pills. - sorry now I'm off the subject .

The workers' compensation insurer is not your sister's friend. They're only job is to make sure that their company pays as little as possible.

The argument your sister will need to make is that she was terminated because she was physically unable to do the work which was assigned to her, which means that her injury is preventing her from doing work and she is thus temporarily disabled.

She has a right to insist that her current doctor is correct (regardless of what the Ombudsman says) and that she cannot work and thus is entitled to income benefits.

While the ombudsman is there to provide her guidance and to help her in the arguments for more benefits, the ombudsman is not an advocate like an attorney. Your sister would be wise to hire a worker's compensation attorney. They are generally paid through an award from the insurer, not by your sister directly. An attorney will greatly increase her odds of winning the hearing.
Customer: replied 3 years ago.

 


Do you happen to know of a workman's comp attorney that will take her case and get paid that way and not charge her every time she needs to ask a question or have him read something?


 


Thank you so much for your help.

JustAnswer does not allow us to directly refer you to lawyers.

However, there are many lawyers in TX that specialize in workers compensation. Most of them work under the sort of fees I've described. She will need to call around to different workers comp firms and talk to a few to see which one she likes the best.

Please let me know if you have any further questions. Please also kindly consider rating my answer positively so that I am compensated by the website for my work on your question. Rating positively does not cause an additional charge and does not prevent us from further discussing your questions.

Best Regards,
ZDN
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