Texas Worker's Compensation - Help For Injured Texas Workers

• Texas Worker's Compensation - Quick facts about worker's compensation law, benefits and lawyer fees.

• Texas Worker's Compensation Resources - Links and resources for injured workers.

Page 1 of 2 12 LastLast
Results 1 to 10 of 11
  1. #1
    Join Date
    Oct 2008
    Location
    texas
    Posts
    1

    Default Maximum Medical Improvement

    It may be in here somewhere, but here is my question. I was hurt 2 years ago, lower back, released back to work with 10% MMI. In the past 8 months or so it have gotten a whole lot worse , to the point it is difficult to walk or sit. My question is, what if anything can I do now?
    Thanks.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Maximum Medical Improvement

    How did, or did it, you claim resolve..?
    Where you paid a lump sum to close the claim..?
    If not...
    Go back to the treating physican, and request treatment.

    IF you did settle the claim...taking the cash payment... you are out of luck on the IC providing any more benefits for this injury.


    BTW... a rating is done by an evaluation of your condition when you reach MMI/Maximum Medical Improvement...the 'MMI' is not rated.
    Your condition is rated for PD/WPI...or Whole Person Impairment..how your injury affects your whole person from competing in the open labor market.
    A 10% WPI is not 'insignificant' in itself, but could indicate more treatment was necessary at the time.

  3. #3
    Join Date
    Jul 2007
    Posts
    64

    Default Re: Maximum Medical Improvement

    I would contact the treating dr. and the insurance carrier. If the current symptoms are the rusult of the previous injury, then it would be handled under the initial claim. In Texas, Medical for the injury is for life. It is not an issue that can be negotitiated. If the current symptoms are not connected to the original claim, then a new claim would need to be filed. Just a note, If the current problems are connected to the first claim, then the monitary benifits are limited by the total of 104 weeks of benifits. Meaning that if you already received 100 weeks of TIBS, then you would only be eligible for 4 weeks of TIBS.

  4. #4
    Join Date
    Oct 2008
    Posts
    17

    Default Re: Maximum Medical Improvement

    This is something caused by your initial injury and can be covered. I believe it's called "Follow-On" injury. I have a cervical fusion, and now I have another disc that is popping out because my initial injury is pushing on it.

    I would see another doctor for a second opinion and file it as soon as possible.

  5. #5
    Join Date
    Nov 2008
    Posts
    4

    Default Re: Maximum Medical Improvement

    I have a question about the same thing and hope someone could help. I hurt my shoulder at work in June. Went to the company doctor for a couple of weeks and really had no improvement. I went to another doctor and found out later the strain was actually a 75% tear in my shoulder. It would require surgery to be fixed.

    I have been back to work since early July trying to figure out how I could afford to be off work for 3 months, due to the amount of pay that Texas limits you to get each week. Or atleast I was told that information, I don't even get half my pay which is the first problem.

    Two days ago I got a letter in the mail stating a MMI and IIB. I have never heard of these before. I was injured in the state of Washington before and never had any of these problems. The letter stated that I had reached my MMI and had a IIB of 0. To me that doesn't sound right at all if I have a 75% tear in my shoulder. Is there something I can do? Or if someone could emplain my options it would be much appreciated !!!

    Thanks

  6. #6
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Maximum Medical Improvement

    If you were MMI then and now you're not it looks like it'll be a new injury even though is in a similar spot.

  7. #7
    Join Date
    Nov 2008
    Posts
    4

    Default Re: Maximum Medical Improvement

    I should say the injury in Washington was totally unrelated to the current one. I was just stating that none of these probelms ever came up.

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Maximum Medical Improvement

    Two days ago I got a letter in the mail stating a MMI and IIB. I have never heard of these before.
    Here is a Fact Sheet for IW's...many of your questions will be answered here...http://www.tdi.state.tx.us/wc/employ...s_english.html
    What are income benefits and how do I get them?

    There are four different types of "income" benefits, each with their own qualification criteria. To learn more about these benefits, please click on the corresponding links.

    Temporary Income Benefits, known as TIBs
    Impairment Income Benefits, known as IIBs
    Supplemental Income Benefits, known as SIBs
    Lifetime Income Benefits, known as LIBs
    I have been back to work since early July trying to figure out how I could afford to be off work for 3 months, due to the amount of pay that Texas limits you to get each week. Or atleast I was told that information, I don't even get half my pay which is the first problem.
    There is a basic calculation on TIB paid..
    Temporary income benefits equal 70 percent of the difference between your average weekly wage and the wages you are able to earn after your work-related injury. http://www.tdi.state.tx.us/wc/employ...fits.html#tibs
    If you are unable to work due to your injury...you receive 70% of your average weekly wage...no taxes on TIB's..

    As you have been back to work for 6 months, your status has changed to MMI because you have not sought treatment to your injury.
    There is no way to determine you IIB benefits because you have not undergone treatment for the injury.

    Go back to your treating physican, discuss and decide on the treatment plan/surgery, and if you are eligible for TIB's your doctor will notify the CA/IC of your status...once you determine to have the surgery.

    THis has nothing to do with your injury in Washington...(yet..that will depend on the body part injured, and apportionment to cause of any PD)
    I was just stating that none of these probelms ever came up.
    WC statutes are state specific, TX has no bearing on WA laws...

  9. #9
    Join Date
    Nov 2008
    Posts
    4

    Default Re: Maximum Medical Improvement

    Thank you for all that information it is very helpful. As far as the 70% of your pay, there is a maximum per week by state law. I believe it was $712.00 In the whole picture 712.00 isn't even half of my 13 week average. I would like to know how they can cap your pay at that number. That is the problem of being out for 3 months after the surgery. That is the whole reason I have been putting the surgery off for now. Trying to save up and prepare for the dramatic pay decrease.

    The funny thing is our company has a OJI bank that will give us 100% pay for the first two months if you are maxed out. I asked them about that and they said sorry it doesn't work that way for me because the state won't allow them to pay more that 712.00 a week. Still every week I was off the OJI bank went down but where did that money go? Like I said 712 is all they would give me but supposedly this OJI money that would give me the difference to make it 100% just dissappears not going to me.

  10. #10
    Join Date
    Nov 2008
    Posts
    4

    Default Re: Maximum Medical Improvement

    One last thing I should say. I wasn't paid every week after I was hurt. They sent all the checks to a address that I had never even heard of after my current address was verified when I was first injured. I only received one check for the total month that I was out. Then two months later they sent me a letter in the mail wanting me to send a check to them for an amount that was more than the total I was even paid !!! Saying I was overpaid. This insurance company is a joke.

Similar Threads

  1. Doc Says Back to Work with No Improvement
    By hangininthere in forum Medical Issues
    Replies: 6
    Last Post: 01-14-2010, 01:02 AM
  2. Maximum Pay
    By flow in forum Tennessee
    Replies: 3
    Last Post: 04-04-2009, 04:46 PM
  3. Replies: 4
    Last Post: 05-12-2008, 09:27 AM
  4. Just Reached Maximum Improvement
    By Rick W in forum Indiana
    Replies: 6
    Last Post: 12-29-2007, 04:21 PM
  5. Maximum settlements
    By tara in forum Hawaii
    Replies: 1
    Last Post: 12-11-2005, 04:05 AM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
 


Find a Lawyer