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Wednesday, February 27, 2008
Medical Bill Collections
Eighteen years after the current workers' compensation scheme
was enacted, medical providers are still billing injured workers for medical treatment related to their work injuries.
The hospitals do this more than any other provider. I saw a claimant yesterday who went to the emergency room right
after his injury and then got a bill for that hospital visit. Before he knew it, he was getting letters from a collection
agency demanding payment of the emergency room bill. He was worried that it would affect his credit rating. If
you are an injured worker, you probably know that your credit rating is the least of your worries.
The good news
is that the Texas Labor Code makes it illegal for a medical provider to bill the injured worker for treatment related to the
work comp injury unless the Division of Workers' Compensation rules that the injury is not compensable. This means
that if your claim is accepted by the insurance company, or the Division rules that the insurance company has to pay your
claim, then the medical provider cannot ever bill you personally. All of the bills have to be submitted to the work
comp insurance company for payment. If the insurance company doesn't pay the bill, then the medical provider has
to fight it out with the insurance company, not with the injured worker.
If you want to see what the Texas Labor
Code says, look at Section 413.042. If you get bills from doctors for treatment that is related to your work injury,
contact the Division of Workers' Compensation immediately and ask them to investigate. The medical provider may
be subject to a fine if they pursue a private claim against you. If that does not solve the problem, consult with me or another attorney immediately.
Texas Labor Code §413.042 is provided here for your convenience:
413.042 PRIVATE CLAIMS; ADMINISTRATIVE VIOLATION.
(a) A health care provider
may not pursue a private claim against a
workers' compensation claimant for all or part of the cost of a
health
care service provided to the claimant by the provider
unless:
(1) the injury is finally adjudicated not compensable
under this subtitle; or
(2) the employee violates Section 408.022 relating to
the selection of
a doctor and the doctor did not know of the
violation at the time the services were rendered.
(b) A health
care provider commits an administrative
violation if the provider violates Subsection (a).
Acts 1993, 73rd
Leg., ch. 269, § 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch. 265, § 3.248, eff. September 1,
2005.
5:08 pm cst
Tuesday, February 19, 2008
TX Work Comp Blog Purpose
The purpose of this Blog page is to provide Texas injured workers with an
avenue to gain information that will help them as they struggle against the workers' compensation insurance industry and
the Texas work comp system that is complicated and convoluted.
It is hard to understand how an insurance company
can decide not to pay workers' compensation benefits when employees get injured on the job. It is harder still to
do something about that.
I will address Texas workers' comp issues as I see them come up in my day-to-day practice.
I am happy to address whatever issues the readers are intereseted in discussing. Please post topic requests to matt.lewis@dallasworkcomp.com. I will include your topic requests in my posts; however, I will not address the specifics of any particular person's
case. If you need advice geared towards your specific problem, then please contact me or another attorney to
discuss that privately and not publicly.
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Who I Am
I am Matt Lewis, an attorney in the DFW Metroplex
who has built a practice dedicated to representing injured workers and medical providers who have problems with Texas workers'
compensation claims. I am Board Certified in Workers' Compensation Law by the Texas Board of Legal Specialization.
I represent claimants (injured workers) before the Texas Department of Insurance - Division
of Workers' Compensation when their claims proceed to a benefit review conference or a contested case hearing. I
will also appeal these cases to the Appeals Panel, and I handle cases that get appealed to the District and County courts
once the administrative proceedings have been exhausted.
I have been representing injured
workers since 1998. However, I am new to the "blogosphere." I hope, in these posts, to provide useful
information regarding workers' compensation in Texas to injured workers so that they can understand this very complicated
system. Please do not accept anything I post as legal advice directed at your specific situation. These posts
will deal with Texas work comp generally. If you need to discuss a specific problem with me, you may contact me at (972)
644-1111, or via email at matt.lewis@dallasworkcomp.com.
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