Buying into these Myths could put your ability to work again at risk!
After suffering an injury working for a Texas non-subscriber, everyone around you is going to begin to offer you “advice” whether you ask for it or not. You need to be careful who you listen to because not everyone offering you “help” or “advice” has your best interests in mind. In fact, some advice that you will hear is 100% meant to keep you from finding out the truth about your actual rights under Texas law! Don’t sit back and try to sort through these myths by yourself! Non-subscriber cases are complicated if you don’t understand the system that they operate in.
- Your Texas Non-subscriber employer “doesn’t have workers’ compensation” so you don’t have a case!
- You can only see the company doctors for your injuries!
- The company doctors are doing everything they can to help you!
- You got injured while on the job so I should automatically qualify for benefits!
- If you didn’t complete a written report, you don’t have a case against your employer!
- If you report an injury, you are going to get fired!
- Your employer, their insurance company and the company doctors want to do what they can to help you recover from your injuries!
Your Employer Doesn’t Have WC Insurance so, No Case, Right?
Nope! This statement is misleading. In Texas, an employer can have workers’ compensation, they can be self-insured, they can be a non-subscriber employer (with an ERISA plan), or, just not have any insurance at all. Following an injury, just because your employer is saying that they do not have workers’ compensation insurance does not rule out that they are either self-insured or, they are a Texas Non-subscriber employer.
Often times, Texas Non-subscriber employers will tell an injured worker that they do not have Texas Workers’ Compensation but, they do not finish explaining that they have coverage for work injuries under an ERISA plan. Hence, there is coverage for work injuries. The best thing to do after a work injury is to insist that your supervisors report your incident and injuries to any insurance that could provide coverage and benefits to you!
You Are Required to See Only the “Approved Medical Providers”
Nope! Again, this statement is misleading. In a Texas non-subscriber work injury case, the care is managed by a third-party administrator (TPA) and they usually provide the names of the clinics where you can go for treatment and, they approve or reject the treatment and tests that the doctors recommend for you. There is no law that requires you to only see the doctors that the TPA or your employer sends you to. They simply want to maintain control of who you see and what they diagnose you with. You can always see your own doctor in these cases especially if you know the insurance is not letting the doctor perform the treatment that he/she feels you need in order to get better.
The Plan Doctors Are Doing Everything to Help you Get Better
No way! Unfortunately, this is not true. As mentioned above, the doctors and the clinics can only perform what physical therapy, tests, CT scans, MRIs, surgeries, etc., that the insurance company approves. Therefore, there are times that even the doctor will tell injured workers that they are making a recommendation for specific treatment but, that they have very little expectation that the insurance company will approve it. The doctors are limited as to what that can do to help you get better. The more expensive the procedures are, the less likely you are to get approved for that treatment. Do not be afraid to seek adequate medical treatment elsewhere.
You Were Injured While at Work So Of Course You Should Get Benefits (Medical and Wage)
Nope! This is a myth that injured workers all too often fall victim to believing. Even if your employer has workers’ compensation insurance, you still would have to prove that your injury occurred while you were performing job duties for your employer. In Texas Non-subscriber cases, just to qualify for benefits, you have to meet all the requirements set out under your employers’ work injury benefit plan, starting with timely reporting the incident that caused your injuries. If you benefits are denied, you could still have a right to sue your employer for failing to provide a safe workplace. That would require proving that your employer was negligent and that your injuries were related to the incident that occurred. There is much to understand here but, the main point is that in any work injury, NOTHING IS AUTOMATIC!
If you Don’t File a Report, You Lose All Your Rights!
Not true! While filing a report is necessary for your to get any benefits under your employer’s work injury benefit plan, you don’t have to have one to be able to prove that you have a negligence case against your employer. Even without a report, your employer can still be found responsible for failing to provide you with a reasonably safe workplace. Therefore, while it is always best to file a report following an incident, you do not lose “ALL YOUR RIGHTS” if you did not file a written or oral report of your incident.
If You Report an Injury to your Non-Subscriber Employer, You’re Getting Fired!
Wrong for both sides! Truth is, there isn’t anything preventing them from firing you at any point. In Texas, employers don’t have to have reason to terminate you. In fact, most employers require to report injuries and, it’s always in your best interest to report an incident and make record of what caused your injuries.
Your Employer and the Insurance Wants You to Get Better and Back to Work
Not really! They want to save money! While some of your co-workers may express to you that they want you back at work, once you are in the claims process for your injuries, you are dealing with company representatives, insurance adjusters and doctors that are motivated by spending as little money as possible in providing you care. If there is a way to blame your injuries on your age, a prior incident or, your genetics, the insurance will find it and will make that argument so that they can justify issuing an adverse benefit determination denying your work injury claim under the plan. So even if all you want to do is get better and back to work, your swimming against the current and you’ll very likely not receive the medical treatment that helps you get better!
Texas Non-Subscribers Companies
Don’t Listen to the Noise in Your Texas Non-Subscriber Work Injury Case!
You’re injured and you want to believe that the employer you’ve worked with for all these years is going to take care of you. That’s understandable but, you have to realize the insurance company is going to be making the decisions and you they’re main concern is taking care of their insured (your employer) and saving money.
Once you suffer a serious work injury, your life will never be the same. Don’t take any chances and don’t delay! The obstacles (listed below) faced by injured workers in the Texas Non-Subscriber case are amplified when you buy into these 7 myths and many others created to tilt the case in favor of your employer:
- Delays in Filing a Report
- Delays in Receiving Proper Treatment
- Delays in Approving Major Medical Exams or Procedures (MRIs, Injections, Required Surgery)
- Being forced to work while your injured
- Cuts in your hours at work
- Denial of your work injury claim
- Termination from your job because you can’t perform the job duties
At Sandoval Law Firm, PLLC, as your attorney, I will make sure that you understand your rights and what we will do to make sure that you get fairly compensated. I will work very hard for you, and I will make sure that expectations are set from the beginning.
An attorney-client relationship is built on trust and confidence, and I take this very seriously. If you’ve been injured at work working for a non-subscriber, do your research!
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