Injured Worker Dealing With A Texas Insurer Outside Of Workers Comp

venom33 · #1 05-08-2007, 03:32 PM

TEXAS. I was hurt at work 12/06 and have been off ever since. i injured both shoulders, ive had surgery and therapy on one and have now started the journey on the other. the company i was employed with DOES NOT have workers comp instead has an insurance policy that covers my medical and i get a little check every week. dealing with the insurance adjuster has been an absolute nightmare!!! ive never met someone as rude as this lady and she threatens me every week to stop my benefits!!also, they have now said they werent gonna cover my other shoulder injury. i signed an arbitration agreement, but was told by my attorney that it can be easily defeated. so my questions are...

1) since they oupted out of comp they are not held under the same rules can i sue their insurance company or the company themselves? 2) should i expect a settlement?(my lawyer says i have a strong case) 3) should theybe reimbursing me for any travel expenses? 4) is this harder or easier without comp? 5)what will the arbitration agreement do in terms of a settlement?

Mr. Knowitall · #2 05-08-2007, 04:47 PM

Your attorney is not able to answer these questions for you?

venom33 · #3 05-08-2007, 04:54 PM

actually, i havent posed these questions to him yet. ive been reading the forum and thought that maybe some folks on here could answer a few of my questions. so please, if you can answer any of my questions that would be greatly appreciated....

cbg · #4 05-09-2007, 03:35 AM

Since Texas is the only state where an employer can legally opt out of the workers comp system I'm afraid I don't know how it works in those cases. Your lawyer would probably be the best source of information. Sorry I can't help.

venom33 · #5 08-08-2007, 01:37 AM

Ok, Im now scheduled for an IME on the shoulder the IC is refusing to cover, what can I expect at the IME???

aaron · #6 08-08-2007, 04:42 PM

You can expect an examination of your shoulders by a doctor who may or may not be interested in providing an objective assessment.

venom33 · #7 08-08-2007, 10:27 PM

What happens afterwards? This will be the third doctor theyve sent me to. Their specialist is the one wanting to perform surgery.... i guess if they send me to enough doctors one will eventually side with them.

aaron · #8 08-09-2007, 10:31 AM

You may wish to discuss your case with a workers compensation lawyer in your state.

abadman · #9 08-29-2007, 02:16 AM

hey man dealing with the same thing. you can sue the employer just get a good lawyer. I got hurt in the back of a trailer it had a whole in the floor and it was covered up with a pallet of frieght. my leg went in the hole and tore a ligament in my knee.The only thing is my knee will not get better already setting up arithis. Talked to my lawyer he said to expect maybe 30-50thousand starting at 50at the top. that does not seem right is there is a limit on the liability in the state of texas i would like to know. I feel that my knee of pain and suffering depression for me and mywife along with not able to have sex because unable to kneel. took that standard test FCE i think but anyway i can not kneel lift more than 50lbs carry more than 35lbs, push or pull no more than 90lbs this is what the test showed. if anyone can help me on the limits of liabilty would be very helpful. it will let me know if i got a good lawyer or someone for the company.

venom33 · #10 09-03-2007, 07:16 PM

Have you had surgery yet? Do you have an attorney? Does your employer have workmans comp?