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MMI rating in Texas when my case isn't over.
#1
Question 
I had an accident at work last year. I hit a steel pipe as I was falling down 5-8ft to the ground and I busted my chin open(5-6 cm) and got 5 stitches/9 staples, hurt my neck , and ended up with annular tear on L4/L5 on my back. One staple was left on my chin and they didn't know until a few months later when I got X-rays again , but they don't want to approve the removal.

My employer sent me home after 3 months of light duty work and didn't work for 6 months and didn't get benefits either. They gave me a job back but they fired me again after a month and a half .. But thankfully I got benefits this time and they paid me for half of those 6 months I was left without a job. The insurance company sent me to a state Doctor where they gave me a 5% IR. My doctor told me I will have to fight it. 

So.. I have a few questions...
I understand 5% means I'm getting %5 x 3weeks =15 weeks of whatever I made on the 13 weeks before the accident. BUT... Will this affect my current benefits??? Will my past benefits be a problem??
Is this all I'm getting or am I supposed to be getting more compensation? 

Honestly I can't do the same thing I was doing back then.. Which is scaffold building.. So I'm really worried about my case.
 
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#2
generally if you get a new IR then the employer will get credit for the 5% they already paid.
it depends if the new disability overlaps with the prior.
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.
 
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#3
(12-09-2015, 10:48 PM)1171 Wrote: generally if you get a new IR then the employer will get credit for the 5% they already paid.
it depends if the new disability overlaps with the prior.

But the benefits I've been getting are because I haven't been working. Would that still be counted as credit for them?
 
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#4
They haven't sent me the compensation for the 5% yet. I just found out I got this rating today.
 
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#5
Temporary Income Payments are not deducted from Impairment Income Benefits.
more on Texas benefit rules here
http://www.tdi.texas.gov/wc/employee/benefits.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.
 
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#6
(12-10-2015, 12:18 AM)1171 Wrote: Temporary Income Payments are not deducted from Impairment Income Benefits.
more on Texas benefit rules here
http://www.tdi.texas.gov/wc/employee/benefits.html

Thank you! So the benefits begin after my case is over? What happens if we decide to dispute the rating because we think it's wrong? Will I be getting benefits according to the average weekly wage for the year I got in the accident(2014) or the current year?
 
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#7
the benefits are:
Temporary Income Benefits | Impairment Income Benefits | Supplemental Income Benefits | Lifetime Income Benefits | Medical Benefits | Death and Burial Benefits

some benefits begin immediately, some start only when certain conditions are met; no benefits are provided after the carrier closes their claims file.

agreeing to an IR rating/amount only finalizes that benefit, it does not close the insurance carrier's claim which has to remain open to pay any benefits agreed to.
review the definitions page from the link I gave you for more information as to the limits of each benefit
if you or they are disputing the IR, then they will not pay beyond what they consider correct.
even though you may think you qualify for more, they are not going to voluntarily "overpay" you.

for more detailed information about the specifics of your claim contact the office of injured employee counsel:
http://www.oiec.texas.gov/

the state website has a lot of information and links for help; take time to review as much as you can.
and, of course, come back and post your questions any time and we'll try to help.
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.
 
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#8
So basically I'm stuck with the 5% the DD rated me as? And they might even not pay me for that if they decide it's not a fair rating?? That sucks
 
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#9
none of that was in any of the information I posted.
you need legal advice.
you can appeal any disputed issue to tthe comp court which decides what benefits you are entitled to.
you are not stuck until you run out of appeals.
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.
 
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