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Legal Services: Workers Compensation

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Ginsberg & Associates Workers Compensation Legal Services

LOOKING OUT FOR INJURED WORKERS

Ginsberg & Associates only represents workers who are injured while working for their employers. The laws are currently tilted towards insurance carriers and their ability to deny your claim for medical treatment and lost wages. Ginsberg & Associates fights hard to make sure injured workers receive the maximum benefits, medical treatment and lost wages, that you are entitled to at law. Contact the Law Offices of Ginsberg & Associates and talk to an attorney for a free case evaluation not a paralegal or case manager about your benefits.

One of the common misconceptions about workers compensation is that if the injury was the fault of the employee then the employee is not entitled to workers compensation benefits. This is not the law in Texas. Texas law only requires that the employee be injured while in the course and scope of his employment. There is no issue of fault to be considered.

The first thing that should be done in any workers compensation claim is to inform your supervisor of the work place injury. This notice should preferably be done by email, letter or note to avoid the supervisor from “forgetting” about being placed on notice at a latter hearing. Even if you think the injury was no “big deal” inform your immediate supervisor and make sure a report of the injury is made. Failure to notify your employer within 30 days of when the injury occurred or when the employee should have known that the injury may be work related results in the claim being barred. Thus the failure to notify, gives the insurance carrier the right to deny the injured worker any workers compensation benefits.

The workers compensation claims process starts with the determination of compensable injury. If an injury occurred while on the clock regardless of fault, then that injury is compensable under the workers compensation system. Once the injury is determined to be compensable, the employee is entitled to medical benefits for that injury. You are entitled to lifetime medical benefits for the accepted injury. Subsequent medical complications such as complex regional pain syndrome and RSD can also be determined to be compensable if caused by the underlying injury. Even preexisting medical conditions can be compensable as workers compensation injuries if the preexisting condition was worsened, aggravated or accelerated by the new workers compensation injury.

The newest trend in workers compensation law, is for the insurance carrier to accept a sprain/strain (ie: muscle pull) to the affected body part no matter the severity of the injury. The Magnetic Renascence Imaging report shows a herniated disc yet the insurance carrier accepts a sprain/strain.

Do not be willing to accept a sprain/strain to a body part. New laws limit the amount of medical treatment you may receive based upon the injury accepted. By accepting a sprain/strain you may be limiting yourself to four to six weeks of physical therapy. All future medical treatment could be denied based upon the sprain/strain classification. If the insurance carrier has already classified your injury as a sprain/strain call Ginsberg & Associates. Our lawyers will attempt to add an extent of injury issue which if successful will allow you additional treatment options.

The second issue is disability. If an injured employee is not allowed to work because of their compensable injury or their doctor places restrictions on what the employee can do and the employer can not satisfy those restrictions, then the employee is entitled to lost wages. Lost wages are called Temporary Income Benefits (TIBS) in the workers compensation system. You are entitled to 70% of your average weekly wage for up to two years from the date of injury.

Your average weekly wage is determined by taking your average weekly salary for the prior 13 weeks. This includes overtime compensation. If you did not work for the employer for 13 weeks prior to the injury, then you take a typical employee in your position and use their income levels for the prior 13 weeks.

Insurance companies attempt to limit TIBS by not including overtime wages in determining the average weekly wage. Insurance Carriers will sometimes issue a bona fide job offer claiming that the offered position meets your work restrictions. In reality the offered position requires you to work beyond your work restrictions. Finally, carriers will also try to claim that the injury was an ordinary disease of life and therefore you not entitled to TIBS.

Make sure that your treating doctor is really looking after your best interests. Often times the employee is referred to the “Company Doctor” by his employer. This doctor is then designated as the treating doctor. The workers compensation system assumes that the employees treating doctor will do everything in their power for the injured employee. If you are going to the “Company Doctor” then odds are that they are looking after the employers interest and not necessarily the employees interests. Call Ginsberg & Associates for a referral for doctor referrals that make sure their number one priority is the employee and not the employer.

Once an employee is determined to be at Maximum Medical Improvement (MMI), they are still entitled to Impairment Income Benefits (IIBS). After it has been determined that there are no further medical improvements which will improve an employees medical condition an impairment rating is assigned for the accepted medical condition. An employee is entitled to three weeks of checks for every point of impairment rating assigned.

If you believe there has been a mistake in the impairment rating, call Ginsberg & Associates immediately. If 90 days passes before you notify the carrier of an impairment rating controversy, then the impairment rating becomes final. A surgery after the date of Maximum Medical Improvement and prior to the end of two years elapsing from the date of the original injury, can be grounds for challenging a final impairment rating. Call Ginsberg & Associates if you had a subsequent surgery after you were found at MMI.

If you received an impairment rating over 15%, you may be entitled to supplemental income benefits. Supplemental Income Benefits (SIBS). Supplemental income benefits can continue for as long as 4 years after you stopped receiving IIBS payments. Contact Ginsberg & Associates to discuss whether you are entitled to SIBS payments or if your SIBS payments have been denied by the insurance carrier. If an employee fails to qualify for four consecutive quarters of SIBS payments then the employee will be denied any future SIBS payments. Contact Ginsberg & Associates to protect your future payments.

If you or someone you know in Texas has a workers compensation issue and needs the assistance of an experienced workers compensation attorney, call Ginsberg & Associates today at 214-369-9871 to schedule a free consultation.

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Phone: (214) 369-9871
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