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Texas Workers’ Compensation: When You Get Released From Medical Care Too Soon

The Texas Workers’ Compensation system has continued to evolve since 1991 when the laws were changed.  Unfortunately, many of the changes affecting medical treatment have more to do with controlling costs for the insurance company rather than actual quality of care for the injured worker.

One of the biggest complaints we hear from our clients is that they were released from medical care before they had a fair chance to fully recover.  This occurs when the injured worker receives enough care to stabilize their condition, but they do not recover enough to return to their previous job’s physical demand level.

Effect Of Treatment Ending Too Early:

When treatment ends, the injured worker is placed at Maximum Medical Improvement, which ends their disability payments.  This puts the injured worker in a position where they are not able to work their normal job, they are not receiving sufficient medical care to help them improve, and they are not receiving Temporary Income Benefits (TIBs) to pay their bills.

Many injured workers are told that they just need to move on with their lives and accept their fate. They may dispute the certification of Maximum Medical Improvement, but, without proof, it is very unlikely that a workers’ compensation judge will overturn the certification.  When treatment ends too soon, this limits an injured workers’ ability to obtain evidence about their ongoing medical needs, their chances at additional recovery, and maximum medical improvement.

Specialized Treatment Programs In The Texas Workers’ Compensation System:

Very few injured workers know about the options available to them in specialized treatment programs which help them to improve their ability to return to work.  Not only do these programs increase a workers’ physical ability, the case law supports a finding that a worker is not at Maximum Medical Improvement if they needed one of these programs.  More importantly, when an injured worker goes through a specialized treatment program and actually obtains a better recovery, they are almost never at maximum medical improvement, from a legal standpoint, until they finish the program.

There are various programs available.  The two most common are Work Hardening and Chronic Pain Management.

Work Hardening:

A Work Hardening program is a structured, goal-oriented, individualized intervention program designed to return the employee to work. They are multidisciplinary (different specialties working together). The program simulates work activities designed to restore physical, behavioral and vocational functions. Work Hardening addresses the issues of productivity, safety, physical tolerances and worker behaviors.

Chronic Pain Management:

Chronic Pain Management (CPM) Programs are utilized in treating complex chronic pain problems with a multidisciplinary treatment approach.  A program generally consists of therapeutic exercises, group discussion, and relaxation training established and monitored by physical rehabilitation and psychological staff.  The goal is to build physical strength and stamina, appropriately use medication, increase pain threshold, learn pain and stress reduction skills and to enhance coping skills to deal with depression, anger and frustration.

Conclusion:

Specialized programs are designed to help an injured worker complete their course of treatment, maximize their recovery and return to work.  When they are used, injured workers have a better chance at restoring their functional abilities and postponing maximum medical improvement.  Not all clinics are able to provide this level of care.

If you feel that your medical providers are releasing you before you are ready to return to your regular work level, speak with your attorney about a referral to medical providers who can provide a program to boost your recovery.

By Matt Lewis, Workers’ Compensation Attorney in Dallas, TX

972-644-1111 or [email protected]

 

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