At the time of hiring or, when a new insurance policy is purchased, Texas Non-Subscriber Employers require employees to sign an Arbitration Agreement. That arbitration agreement requires that any disputes arising out of the employment, between employer and employee, be submitted to arbitration for resolution of the dispute. This agreement applies to any dispute arising out of an on the job injury. So, if you are injured while working for a Texas Non-Subscriber, if you signed an arbitration agreement, your case against your employer cannot be filed in State of Federal Court. YOUR CASE MUST BE ... Continue Reading
Texas Work Injury – Texas Non-Subscriber
Houston Texas Blog About Work-Related Injuries, including Texas Non-Subscriber Cases
Contact Sandoval Law Firm, PLLC at (346) 347-7777 to request an initial consultation to discuss your case.
Should I Go Back to Work After Only One Visit to the Doctor?
If you get injured at work and you’re sent to the first doctor’s visit but, the doctor does little to determine how injured you are and, you’re sent back to work, should you go back? In short, if you want to keep your benefits, you must follow the recommendations of the physician that you saw even though he may have your employers’ and the insurance’s interests in mind instead of yours, as an injured worker. If you are hurt and you are concerned that you might injury yourself more if you go back to work, you need to make sure you follow the restrictions the company doctor sets for you but, ... Continue Reading
What Is an Employment Benefit Plan or a Summary Plan Description?
ERISA (Employee Retirement Income and Security Act of 1974) is the federal law that allows Texas Employers to provide coverage to injured workers under a WELFARE PLAN. In a nutshell, instead of providing injured workers coverage for medical benefits and lost pay under Texas Workers’ Compensation Laws, Texas Employers that adopt ERISA Welfare Benefit Plans provide coverage to injured workers under ERISA and not Texas Worker’s Compensation programs. TEXAS EMPLOYERS THAT PROVIDED INJURY COVERAGE TO EMPLOYEES UNDER AN ERISA PLAN ARE KNOWN AS TEXAS NON-SUBSCRIBERS. If an injured worker is being ... Continue Reading
I Could Work Without Pain Before My Work Accident, How Can my Injury Be Pre-Existing?
Pre-existing conditions in work injury cases Work injuries can happen in variety of ways. Because our bodies change through the natural process of aging, employers and their insurance companies rely on test results showing degeneration (age-related changes) to argue that your injury is Pre-Existing. The can use age-related changes seen on X-rays or MRIs to argue that any work injury you are claiming is really a result of natural processes and you do not have a true new (acute) injury. First of all, you should never believe a physician who is telling you that all your complaints of pain are ... Continue Reading
If I Get Injured at Work, How Do I Know If I Can File a Lawsuit Against my Employer?
If you get injured on the job, whether you are able to file a lawsuit against your employer depends on a couple of things. First, you must first be able to identify if your employer is Texas Workers’ Compensation Subscriber or, if they are Texas Non-Subscriber? Second, you have to be able to determine if you’re employer’s NEGLIGENCE caused your injury. If your employer has Texas Workers’ Compensation, then, the general rule is that you cannot file a lawsuit against your employer for any negligence that caused your injury. One of the fundamental differences between an injured worker’s rights ... Continue Reading
In a Work Injury, What Steps Should I Take to Make Sure I’m Protecting My Rights?
If you haven’t reported the work injury, call your employer now How? Send an email or leave a voicemail letting them know when you were injured! If you’ve been seriously injured at work, the best way to ensure that your rights will be protected is to report the injury and get the necessary medical attention immediately! Call and put Sandoval to work for you! Every case is different but, below are some general recommendations if you are injured on the job: REPORT THE INCIDENT! REPORT YOUR INJURIES! It does not matter how minor it may seem or if you don’t really know what type of ... Continue Reading
If I Have an “Incident” at Work, Why Is it Important to Report Immediately?
Non-Subscriber claims are set up in such way that, if you don’t report the injury within a certain timeframe, usually 24 hours, you could be denied wage and medical benefits. We all know that sometimes following an accident, you don’t always know if you’re really injured or, you don’t know how serious the injury is. We naturally try to give it some time and see if the pain or discomfort will simply go away. When you have an injury incident at work, you cannot “give it some time” because it will affect your ability to prove that your injury came about from a specific incident at work. It’s ... Continue Reading
Texas NON-SUBSCRIBER Case: What is an Adverse Benefit Determination?
An Adverse Benefit Determination after you see the IME doctor If you’ve been receiving treatment and then, suddenly, you are asked to go see a doctor for the first time, chances are, that examination is a Defense medical examination or an IME. After you see the IME doctor, you typically will receive a letter with the report informing you that, based on the good doctor’s examination, your benefits have been terminated. That letter informing you that your rights have been terminated is an Adverse Benefit Determination. It informs you that you a have a right to appeal the decision, but you have ... Continue Reading
Texas NON-SUBSCRIBER Case: What is an Independent Medical Examination (IME)?
What is an IME? If you’ve been injured working for a Texas Non-Subscriber employer, you may have received some treatment and then you’ve been asked to go see a doctor for an Independent Medical Examination or an IME. What is an IME? First of all, it’s not INDEPENDENT in any sense of the word. It’s the set-up. This is a Defense ordered and payed medical examination where essentially you are going to see a “doctor” for the first time and he is going to answer some questions asked by the insurance company. For example, whether your injury is related to the work accident or whether, at this stage ... Continue Reading
In My NON-SUBSCRIBER Case: Why Won’t the Adjuster Approve an MRI?
The truth hurts. In a nutshell, the adjuster in your case is delaying your treatment because they don’t want to have documented evidence of your injury. Approving tests that confirm that an injury is work related is not in the best interest of your employer and of the insurance company. This is also why the adjuster tells you that you cannot go see your own doctor. Well, you really can but, it will be at your expense. It’s not always possible to go see your own doctor and so an injured employee usually elects to wait for approval of the recommended tests, like an MRI. Remember that insurance ... Continue Reading
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