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What to expect in TEXAS. - Printable Version

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What to expect in TEXAS. - CraneKrasher - 09-21-2013

Starting with the accident...August of 2012 the crane I was operating had a critical malfunction causing to boom to collapse. I was ejected from the machine and fell approximately 20 feet landing in a akward position and in severe pain. Mechanical failure was the result. No drugs, alcohol, nor horse play involved.
Injuries:
Neck has per MRI results, shallow left posterolateral annular fissure and disc protrusion at C5-6, and very shallow posterolateral disc protrusion at C4-5 with minimal cord abutment.
Lower Back per MRI results, displaced lumbar intervert disc. L2/3 has 2mm disc bulge. L3/4 has 3mm disc bulge. Sprain/Strain Lumbar Region.
Uns Neuralgia Neuritis/Radiculitis.
Left and Right Shoulders, Torn Rotator Cuffs.
Since the accident I have received TIB, and medical treatment. So far on the left shoulder was repaired with Open Rotator Cuff Surgery. Due to the long waiting period for WC to approve the surgery, and trying alternative treatment per WC, the surgery was not 100% successful.
Doctors as well submitted for requested for injections (under anesthesia) for Cervical ESI,...only to be denied by WC.
Per orders I receive PT 3 times a week, and ungodly amounts of pain medications. However, even I know pills and PT will not help.
Anyway, I do get the maximum amount per week, ($700.00) but even though this sounds like a lot you must consider what I was making prior to the injury. So, my question is.....Is there light at the end of this road? I am 47 years old with three small babies and will never be able to return to my field of work. You cannot be taking pain medication if you are a Crane Operator.
I have not reached MMI and not given a IR. I have been to 2 designated doctor reviews and one of them states, "I have determined that the examinee has not been afforded the opportunity to obtain MMI". The other review states, "...but since he has not been offered the opportunity to receive the appropiate care...".
Anyway, bottom line is this. I know there are NO "settlements" with WC in the State of Texas, what would be a ballpark figure if the pay me off? Lets just say 50% IR to be on the low side.... And if they do pay me will I be able to keep medical?


RE: What to expect in TEXAS. - 1171 - 09-21-2013

if there are no settlements, wouldn't it be illegal for them to pay you off? or is there some confusion about what "settlement" means?

here is an explanation of how impairment Income benefits are calculated.
http://www.tdi.texas.gov/wc/employee/impairmentben.html
you can receive impairment benefits and continuing medical treatment once you've reached MMI.

there is no way for someone not familiar with the details of your case to estimate the cashout value of your future medical benefits.

for help with return to work and vocational rehabilitation try these:
http://www.tdi.texas.gov/wc/rtw/index.html
http://www.dars.state.tx.us/
http://www.tdi.texas.gov/wc/rtw/documents/wkgwks.pdf
http://www.tdi.texas.gov/wc/rtw/registry.html


RE: What to expect in TEXAS. - jayne - 09-21-2013

welcome, AGA will be the best member of this site to answer your questions about Texas WC fill free to PM him However he is going to school so it may be a day or two to get your answer the rules are above in 1171's post but if you want someone who has lived it AQA is your man.


RE: What to expect in TEXAS. - CraneKrasher - 09-21-2013

(09-21-2013, 08:05 PM)jayne Wrote: welcome, AGA will be the best member of this site to answer your questions about Texas WC fill free to PM him However he is going to school so it may be a day or two to get your answer the rules are above in 1171's post but if you want someone who has lived it AQA is your man.

Thanks


RE: What to expect in TEXAS. - AQA - 09-22-2013

Well now I know why my ears were ringing today.

Hey sis, Whats up??

CraneKrasher, I have been dealing with Texas WC since 8/12/05. Since I started dealing with them. News laws have past and taken effect. The last I saw my neurosurgeon we spoke about the law that deals with the IC not covering certain meds. for chronic pain. I will be seeing him on Tuesday and I am sure the conversation will continue.

Anyway, one thing has not changes and I don't see it changing. It pertains to something you said, and I quote "Anyway, bottom line is this. I know there are NO "settlements" with WC in the State of Texas, what would be a ballpark figure if the pay me off? Lets just say 50% IR to be on the low side.... And if they do pay me will I be able to keep medical?"

First off I think the meds are messing with you or mine are messing with me. The words settlement and "pay me off" have the same meaning. The IC settle with WC claimants to pay them off. So they no longer have to hear from them or have any other dealings with their claim.

Please do not compare Texas WC with the WC from other states. Texas is different then that other states.

You stated that you are receiving TIBS and your DOI 08/12. In the state of Texas, you can be placed at MMI by a doctor at any time. If you have not been placed at MMI by a DR, you will be placed at MMI two years from the date of the injury per state statue.

You will continue to receive your TIBS until you are at MMI. Once at MMI, you will receive an impairment rating. If you are unlucky enough to receive a 15% impairment rating or greater. Then you will be receiving LIBS. (I used the word unlucky because, that would mean your medical condition is real bad and I wish no one to be in that condition). Anyway, For each impairment rating point, you will receive 3 weeks of IIBS. That will be about 70% of your TIBS.

As far as medical goes. In the state of Texas, Medical is for life.

Just a note, I am disabled and receiving SSDI. My IR was 10%

Take Care


RE: What to expect in TEXAS. - CraneKrasher - 09-22-2013

Thank you for the responses. I will update this after the Benefit Review Meeting on the 27th of this month.


RE: What to expect in TEXAS. - AQA - 09-24-2013

If you don't mine me asking?? Why the benefit review meeting???

Generally there is a reason for a BRM.

If you don't want to say, I understand.


RE: What to expect in TEXAS. - CraneKrasher - 10-02-2013

AQA. The BRM was for extent of injuries review. Bilateral shoulders, neck, lower back, internal, and nerve. Just returned from the hearing. Some was accepted and some not. Now going to the hearing in front of Judge.