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1st Time Private Business Claim - Need Advice/Info
#1
Question 
Howdy!

In accordance with the Texas Workers Compensation / Texas Insurance Board's rules, I have informed my employer TODAY of a work-related condition that is causing me pain and suffering.

I have been perusing the websites of the afore-mentioned commission and board, and find some needed information is missing.

These may be very easy and mundane questions that are clear to some, but right now, they are as clear as mud to me. I'll begin with this one:

My employer does participate in the TWC program and by TWC rules, I have to go to a provider that my employer's insurance participates with. How long should it take my employer to send me to a Dr. to get evaluated? I worked for a local municipality for years and was injured on the job several times, and I went Immediately to the Occupational Health Clinic for evaluation and treatment.

I do not want to inundate the forum with questions, so I will ask them one at a time.

Any advice / input is appreciated. - Thanks
 
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#2
"A certified WCNet is responsible for arranging health care services for injured employees 24 hours a day, seven days a week. A certified WCNet must arrange these services within a certain mileage radii and within no later than 21 days. For additional information and listing of a certified WCNet's responsibilities please see Chapter 10 of the Texas Administrative Code and Chapter 1305 of Texas Insurance Code.
http://www.tdi.texas.gov/wc/wcnet/indexw...ml#RespWCN

the medical network provides treatment for your injury; not just evaluations.
you can also contact the network directly.
http://www.tdi.texas.gov/wc/wcnet/wcnetworks.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
P.S. if there is an employee bulletin board or an employer website network information is often posted there.
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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#4
I appreciate the information - it was something that I had not been able to find.

My main problem is that I am dealing with a boss (one of 6 branches of the company) who is taking this whole thing personally. He just told me on the phone that "I just spoke to _____ and they said you can't come back to work until you get a Doctor's release"

I wanted to say "Hey you moron - This is just started and I cannot work m y job like this!" but instead I said, "Sir, I can't do ANYTHING until I get evaluated from the network Dr. that you provide. The company has an insurance carrier who is the provider for the TWC system, and by law I have to choose from the list YOU give me of doctors in the network. That is what I am waiting for you to provide to me by law."

He said: "I know everything you just said, and I don't know that information." I told him "Well ______ is the name of our TWC Insurance provider and the company (I work for) has to provide me a list of the doctors in that network who can see me."

He said "Well I don't know who you can see, but you can't come back to work until you get a clearance."

Grrrr...

I texted him after our conversation and asked "Do we have an HR - Human Resources - person and who is it please?" He replied "I don't know - I'll see about it."

Fun part is, yesterday he told me to hold-off coming into work until HE gets it sorted out.

Like I said, he is taking all of this personally, and does not want to face the fact that I know much more about the law than he does, having been through this 3 times before. I strongly believe he is taking this too personal based on other conversations and since this is his first management job (that I know of) he does not want to appear incompetent or unknowing of the law to his superiors.

Thanks
 
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#5
Actually the opposite is true: you can,t be off work whether on comp or on medical leave without a doctor's authorization.
He seems to have gotten the cart before the horse.
Unles he's claiming a safety issue exists....
He can put you on paid leave until your status with the job is clarified.
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
#6
" He can put you on paid leave until your status with the job is clarified."

I guess this is what he has done by telling me to not come in until he "gets back to me".

I do not want this to become adversarial, but i believe it is going to anyway and I believe he will try to
terminate me if I "go over his head" and reach out to whoever is the HR rep for the company.

I already know he goes around his bosses' backs in some of his business dealings and I do not want
to bring that up, but I know he is working something here.

Thanks
 
Reply
#7
Advise get a lawyer,don't deal your self with incompetent manager don't try to saved money not hiring a lawyer.Give a piece of your cake,even when you has been in this before
 
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