The Morris Law Firm Blog

April 30, 2012

TEXAS WORKERS COMPENSATION DWC-69

Filed under: Workers' Compensation — Tags: , , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 7:40 pm

I was in a Contested Case Hearing this week.  The issue before the hearing officer was maximum medical improvement and impairment rating.  We had a DWC-69 from the treating doctor that said the claimant was not yet at maximum medical improvement.  The insurance company had a 5% impairment from a post DD RME.

Finally, we had the DD (Designated Doctor), who had a DWC-69 with a 5%.  But in the body of his report, the DD stated that the actual impairment was a 15%.  He went on to state that his previous report included the causation of the full injury and all together it should be 15%.  The 5% was for what the insurance company’s letter stated was compensable.

Thank you Matt Lewis (www.dallasworkcomp.com) for sending me over the Appeal Panel number I needed during the hearing.  I remembered the nature of the case.  But, I couldn’t remember the number and I was with a new judge who didn’t know it.

Appeals Panel Decision No. 111393 states that although there was no DSC-69 in evidence to support the hearing officer’s decision.  However, the Appeals found that it was proper for the hearing officer to rely upon the evidence in the medical records.

With all the pressure that the Division of Workers Compensation is placing on the Designated Doctors, it is nice to see that we can actually look at the reports and not just a form with the blanks filled in.

Daniel L Morris

The Morris Law Firm

(214)357-1782

info@themorrisfirm.net

April 18, 2012

Complex Regional Pain Syndrome in Texas Workers’ Compensation Cases

Filed under: Workers' Compensation — Tags: , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 4:22 pm

I first started handling Texas Workers’ Compensation claims in 1996.  During my first year of practice, a lady walked into the office that had been diagnosed with Reflex Sympathetic Dystrophy (RSD).  The insurance carrier had accepted injuries to her bilateral hands and wrists, but they were disputing the RSD.

At that time it was difficult to even find doctors that were able to treat her symptoms, let alone assist with the causal connection to her compensable injury.  It required a lot of research into how to help her.  Since then we see a few of these cases per year.

Reflex Sympathetic Dystrophy (RSD) is also known as Complex Regional Pain Syndrome (CRPS) or Causalgia.  It is a chronic progressive neurological condition that can affect your skin, muscles, joints and bones.

Reflex Sympathetic Dystrophy generally arises from limb that has been injured.  This is true even from what appear to be minor sprain/strain injuries to an extremity.

The symptoms include:

-          Burning pain                                                   -Extreme sensitivity

-          Skin color changes                                       -Skin temperature changes

-          Muscle Spasms                                                -Tremors

-          Weakness                                                        -Migraine headaches

-          Excessive sweating

Reflex Sympathetic Dystrophy is difficult to diagnose.  A thorough history and neurological examination should be done.  The medical provider should note if mild sensory stimuli produces severe pain.  The examination should include notation of swelling and vascular reactivity, overgrown and grooved nails, stiff or weak joints and atrophy.

To be found compensable, you must prove by a preponderance that the RSD/CRPS naturally resulted from the compensable injury.

Daniel Morris

The Morris Law Firm, PLLC

(214)357-1782

info@themorrisfirm.net

April 12, 2012

Texas Workers’ Compensation Income Benefits

Filed under: Workers' Compensation — Tags: , , , , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 6:27 pm

When a Texas worker is injured in the course and scope of their employment (their employer must be a subscriber), there is an insurance policy that covers their injuries.  This insurance policy pays 100% of the medical care for necessary and reasonable medical care.  In addition, injured workers receive payments for disability and their impairments.

Types of Benefits:

Temporary Income Benefits:

Temporary Income Benefits (TIBs) are paid weekly to the injured worker prior to being placed at maximum medical improvement, when the worker is unable to earn the same income they received prior to the accident.  Temporary Income Benefits are generally paid at 70% of the pre-injury average weekly wage.  Make sure the amount includes any fringe benefits received from your employer.

Impairment Income Benefits:

Impairment Income Benefits (IIBs) are benefits you receive after you are found to be at maximum medical improvement.  When an injured worker is found to be at maximum medical improvement, they are also given an impairment rating from 0-100%.  For each point of impairment, the injured worker receives three weeks of Impairment Income Benefits.  The benefits are not for disability, they are paid even if the worker is working full time.

Supplemental Income Benefits:

Supplemental Income Benefits (SIBs) are paid to injured workers that receive an impairment rating of at least 15% and are not capable of returning to their previous type of employment.  Supplemental Income Benefits are paid monthly to injured workers who are completely unable to work, are actively engaged in seeking employment, are currently in a full time DARS approved program or are currently earning less than 80% of their pre-injury average weekly wage.

Lifetime Income Benefits:

Lifetime Income Benefits (LIBs) are generally paid weekly to injured workers who have an injury to their head that results in what the Division of Workers’ Compensation defines as incurable insanity or permanent imbecility.  Additionally, an injured worker may be entitled to Lifetime Income Benefits if they loss one of the following:

1)      The loss of use of both feet at or above the ankle;

2)      The loss of use of both hands at or above the wrist;

3)      The total loss of sight in both eyes; or

4)      Certain combinations of the above.

Death Benefits:

Death or Beneficiary Benefits are paid to dependents of a worker who dies as a result of the compensable injury.  This may be due to the results of the accident, treatment or medications taken for the effects of the accident.

Daniel L Morris, The Morris Law Firm, PLLC

(214)357-1782

info@themorrisfirm.net

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