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 ... Continue Reading
Texas Injury Resources
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 ... Continue Reading
Why Houston is Nationally Ranked in the Top 3 for Fatal Car Accidents
Although we call them car accidents, the truth is most fatal car accidents are no accident at all. They’re “incidents” that could have been avoided had the responsible party not acted negligently and followed the rules of the road! Houston ranks in the top 3 for fatal car accidents in the United States. There are several reasons for why Houston ranks so high on the list. Unfortunately, many of ... 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’ ... 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, ... 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 ... 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 ... 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 ... 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 ... Continue Reading
