Texas Workers’ Comp Division Assesses $63K in Penalties

April 17, 2008

  • April 28, 2008 at 10:03 am
    Jr. Leach says:
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    While this is a start to a long period of change there is more that still needs to happen. I have been hurt with a serious back injury since July 2007 from on the job. I have taken all the conservative treatment therapy, epidural injections up to 9 total and was told to about back surgery would help me. After thinking about it and getting 2 separate opinions from a doctor of my choice and a company doctor I know that the surgery will help me walk better and relieve the majority of my back and leg pain. The only problem is that this thing called Texas Workers Comp. is so tricky and messed up. I have been ordered by the TWCC and the Insurance Company to see a designated doctor 3 times now and they all agree with my surgeon so you ask whats the problem? Well every time the designated doctor agrees with my surgeon the Workers Comp. Insurance Company hires a Physician Advisor to disagree with the designated doctor and and my surgeon. We appeal it and the Physician Advisor for the Insurance Company Agrees with them. I am purposing a law that stops insurance companies from taking a easy way out and sending the records they want the Physician Advisor to see that they hire and pay to agree with them and make a law where the Physician Advisor can only make a decision on thats persons case when they have seen the person so that means the Physician Advisor had to be picked locally or make a decision after talking to the patient over the phone or web cam via the internet or whatever, yes I already know they contact the doctors office to talk to them also but why not the patient? What can this hurt. So where am I now? Waiting on a PLIF with the cage and plates with screws for L-5 S-1 and the insurance companys Physician Advisor to make a decision. What does the TWCC say about all this? Our hands are tied with the current laws and we cant do much about this current situation they said . And oh yes you can file a complaint about it. Well after all this I was told by the TWCC today that the Insurance Company could appeal it as much as they want. I said well man that just leaves me and allot people up the creek with a paddle. The TWCC customer service rep. told me if you dont like the law do something to change it so I am going to try.

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