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Texas help please
#1
Hi everyone,
New here so hopefully I'm not asking something that's been asked before.
I work for a large company as a truck driver hauling oil. Approximatly 4 monthes ago I dropped my motorcycle tearing my miniscus on my knee.
I had it repaired and was out on short term disability for almost 3 monthes.My company has chamged the way they pay us for STD and now pay us $90 per day minus insurance and taxes ssi. For vacation they pay us our daily average we are paid by the load. I had a good daily average prior to my injury I think around $300 per day
. While I was out on the mend this company really messed up and lost our number one client so I came back to anywhere from $60 to $200 a day.The last couple weeks we have got our customer back and I've done pretty good. Except my knee has really been bothering me every so often when so i went back for my followup I told the surgeon that I believed there was a piece floating around in there. Because I would be able to walk pretty good than all of the sudden my knee would have a sharp pinching type pain. He ordered an MRI which I have for my appointment on Monday.
This Saturday morning I was finishing my last load and where we dump the oil I had walked over to get my last meter reading when I tripped over conduit that runs to this area where we dump the oil. I tripped falling forward and struck my face on the lac (machine which pumps the oil off our trucks and meters it). I landed first on both knees and fell face first striking my face. My nose had blood pouring out, my lip was cut, and both knees hurt and were scuffed through my pants. The ground is rock.
I called my supervisor and he took me to the hospital. They xrayed my face and the knee I had my surgery on.The doc said I most likley had small fracture in my nose, he glued the laceration on my face, and told me to follow up with my regular doc as I told him I already have an appointment Monday with my orthopedic surgeon. He perscribed pain meds. and wanted me on crutches which I declined because I wouldn't be walking much as I was going on nights off.
My questions
1) They told me to call unum ( our disability insurance co.) Monday morning. Unum handles their workers comp and disability. My company is self insured. From what I understand I will be paid for time off which is computed using my last 13 weeks of wages and dividing by 13. Since my last 13 weeks include a bunch of vacation time and before that short term disability how do they have to compute my wages? As that is not wages but benifits.
2) They told me to go to my doctor for my nose but I have read you are supposed to go to workers comp doctor?
3) I already had my appointment for my knee. They did not xray my other knee which hurts also I quess because I was putting all of my weight on it but I want to make sure it's ok.ER doc just looked at it but never touched it. When I see my knee doc monday I will have to pay my copay. This visit now is also going to be workers comp injury as my already bad knee is really bad now but I don't know how much more. I also have copy of xrays from hospital. I also want my other knee xrayed if he feels it should be.Who pays my orthapedic surgeon now?
4] The ER doc said my GP needed to see my nose that he thought it had a small fracture aoso but discharge papers say contusion.Who pays my regular doc?
I am low on money wnd this just adds to that problem if I have to pay more co oays and percentages on diagnostics and procedures.
Thanks for any answers in advance sorry so long Smile
 
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#2
you should contact the work comp administrator for information about your claim.
1) "If you did not work for your employer for 13 weeks before the work-related injury or illness occurred, your average weekly wage may be calculated using the earnings of an employee with the same or a similar job."
http://www.tdi.texas.gov/wc/employee/incomeben.html#aww
2) check with unam to find out what doc they want
3) if unam accepts your treating for comp they will pay it as comp. you don't get to decide what tests are needed.
4) if unam accepts your regular doc for comp then they will pay it as comp.

information on medical benefits and network approved doctors
http://www.tdi.texas.gov/wc/employee/medicalben.html
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
Reply
#3
(02-23-2014, 08:27 PM)1171 Wrote: you should contact the work comp administrator for information about your claim.
1) "If you did not work for your employer for 13 weeks before the work-related injury or illness occurred, your average weekly wage may be calculated using the earnings of an employee with the same or a similar job."
http://www.tdi.texas.gov/wc/employee/incomeben.html#aww
2) check with unam to find out what doc they want
3) if unam accepts your treating for comp they will pay it as comp. you don't get to decide what tests are needed.
4) if unam accepts your regular doc for comp then they will pay it as comp.

information on medical benefits and network approved doctors
http://www.tdi.texas.gov/wc/employee/medicalben.html


Thanks so much that answered all my questions! !!
 
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