What Do New Workers’ Comp Disciplinary Actions Mean for Texas Workers?

Austin Personal Injury Attorneys Explain Workers’ Comp Violations

The Division of Workers’ Compensation (DWC) has recently released information about fines levied against companies that failed to provide health care and workers’ compensation benefits to injured workers. In the first ten months of 2014, the DWC has issued nearly $1.8 million in penalties, mostly to insurance carriers. Healthcare providers, employers and other entities were also fined.

What Are Common Violations by Insurance and Healthcare providers?

The insurance carriers account for 93 percent of the total penalties. Examples of violations include the following:

• Failing to pay income benefits to injured employees in a timely manner.
• Failing to pay medical bills on time.

Healthcare providers received the second highest amount of fines. Their penalties amounted to $65,600. Their most common violations include:

• Failing to document an injury in such a way as to allow for continuing rehabilitation or medication when needed.
• Inaccurate or incomplete DWC paperwork.

What Happens to Companies that Fail to Provide Benefits to Injured Workers?

Punishments vary based on the severity of the violation. The Hartford Insurance Company, for example, was fined $40,000 for failing to pay income benefits and refusing to comply with the Texas Workers’ Compensation Act.

Another healthcare provider was permanently removed from the Texas workers’ compensation system. It was providing care that violated the commission’s standards.

Why are Benefits Denied?

Your benefits may be limited or denied due to a misdiagnosis of your injury. This happens with injuries like traumatic brain injuries that take time to show symptoms, or if medical equipment malfunctioned during your exam.

Discrepancies between the definition of “workplace injury” can also prevent or delay workers’ compensation benefits. For instance, an employer or an insurance company may argue that a worker was not at work when the injury occurred and does not qualify as a “workplace injury.” An injury that occurs while traveling to work would probably not qualify as occurring within the scope of your employment, but if you get into a severe car accident while on a work-related errand, you likely would be entitled to benefits. Employers or providers could also dispute an injury that occurs after the official end of the workday, even if the accident occurred on the job site.

No matter the circumstance, if you have been injured on the job, you may need to pursue legal action to get the compensation you need to recover. Insurance companies do not always have your best interests in mind when making decisions about workers’ comp benefits. If you are having any trouble with your claim for workers’ comp, then contact our Austin workers’ comp attorneys today.

Source: http://www.workcompwire.com/2014/10/tx-division-of-workers-compensation-announces-recent-enforcement-actions-17/