FAQs

A. Are independent contractors covered by Worker’s Comp?

Independent contractors are not eligible for workers' compensation coverage; employers are not required by Texas state law to purchase coverage for independent contractors. However, some employers misclassify employees as independent contractors to avoid paying payroll taxes and workers' comp premiums for them. Especially when a worker is injured, an employer may try to deny that the worker was an employee.This does not mean that the employee does not have rights. A good attorney is necessary at this point to handle the independent contractor’s claim. A serious injury to the independent contractor leaves them open to large medical expenses and lostincome. This would be the appropriate time to consultwith an attorney about the facts of employment law. If the employer deniesany employment relationship, there will generally be an application for a hearing to resolve the coverage issue.

 

B. What if my employer is a non-subscriber?

The term nonsubscriber is commonly used to identify businesses that do not “subscribe” to workers' compensation. In Texas, employers may elect not to carry workers' compensation. 44% of all Texas employers are non-subscribers. An attorney will work with you to shownegligenceon the partoftheemployer. With the help of an attorney, theemployee must provethat the employer:

1. Failed to maintain adequate staff to perform the job safely

2. Failed to maintain safe premises and working conditions

3. Failed to provide or maintain the necessary equipment to perform the job safely

4. One of the supervisors or employees was negligent

C. What are the types of work related injuries?

• Physical injuries

• Psychological injuries

• Occupational Diseases

Occupational diseases can affect anyone in almost any type of profession. Construction, food service, and farming are the more commonly known high risk occupations. Additionally, jobs that deal directly with toxic gases, solvents, mineral dusts, pesticides and nitrogen compounds can also pose a high risk to workers.Some examples of occupational diseases include but are not limited to:

• Lung diseases

• Heart diseases

• Histoplasmosis

• Hearing loss due to noises

• Reactive Airways Dysfunction Syndrome

• Asbestosis

D. Who is eligible for Death and Burial Benefits?

Death benefits are paid to:

• surviving spouse

• dependent child

• dependent grandchild

• other eligible dependent family member of an employee killed on the job.

Except for the spouse and minor children, other family members must have been at least 20 percent dependent on the deceased worker's income to receive death benefits.

 

E. I think I am ready to go back to work, but my doctor has not released me.

You don't have to be completely recovered to go back to work - in fact, you might be able to return to work while you are still healing. To do this, you should:

• Talk to your doctor. Tell him about your regular job and other jobs in the company. This will help him to determine what type of work you can do safely.

• Talk to your employer. Let them know you want to come back to work. When your doctor says it is safe to return to work, let your employer know so that they can try to find work within your restrictions, if any.

• Find out if your employer has a Return to Work Program. Return to Work is a program set up by an employer to help injured workers go back to work more quickly and safely while they heal - either with changes to their regular job or in a temporary, alternate work assignment.

F. Can IIHC help me anywhere in the state of Texas?

We provide our service all over the state of Texas including:

Amarillo, Austin, Beaumont, Brownsville, College Station, Corpus Christi, Dallas, Denton, El Paso, Fort Worth, Houston, Laredo, Lubbock, Lufkin, Midland/Odessa, Missouri City, San Angelo, San Antonio, Tyler, Victoria, Waco, Weslaco, Wichita Falls

 

G. Am I entitled to prescription reimbursements?

If you were prescribed medications by a doctor treating youfor your work-related injury or illness, you may requestreimbursement from the insurance carrier.

 

*You are not entitled to reimbursement from the insurancecarrier for the difference in cost between generic andbrand name drugs if a generic drug was available and youchose to purchase the brand name.

 

Request for Reimbursement
Hiring an attorney to help you through this process is advised. Here are the steps to reimbursement:

1. To receive reimbursement for your out-of-pocketexpenses, you must submit a request for reimbursementto the insurance carrier. The request should be submittedas soon as possible after the date you purchased theprescription(s).You may submit a copy of the information sheet providedby the pharmacy. Cashregister receipts alone are not sufficient to support yourrequest.
   
   

2. The insurance carrier must respond to your request forreimbursement within 45 days of the date the insurancecarrier receives your request. The insurance carrier willeither pay you or notify you in writing of the reasons forany reduction or denial of reimbursement.

IIHC will find you an attorney to handle the following:

1. Denial of Request for Reimbursement - If the insurance carrier denies your request for reimbursement.

2. Medical Necessity Dispute - If the denial of your request for reimbursement statesthe prescriptions, or over-the-counter alternatives are not medically necessary.

3. Compensability/Extent of Injury/Liability Dispute - if the denial of your request for reimbursement states theprescriptions or over-the-counter alternatives are for anunrelated or a non-compensable (payable) condition, orstates that the insurance carrier is not liable for the claim.

4. Medical Fee Dispute - If the denial of your request for reimbursement pertains tothe amount of money you have requested to be reimbursedand not to medical necessity, compensability, extent of injury, or liability.

Medical
Our clinics are dedicated to providing comprehensive, safe and effective care for our patients. Our team of specialized healthcare professionals includes physicians, chiropractors, anesthesiologists, social workers, physical therapy specialists and more. We offer unique treatment programs for acute and chronic injuries and pain management, workers compensation patients and auto-injury patients,

• Auto injury and workers compensation claims processing

• Same-day appointments

We offer a wide range of treatment and claims processing services for patients who have suffered a work-related injury. Our team of experts provides:

• Free consultations for work-related injury patients

• Complete medical diagnostics and evaluation

• Ongoing progress evaluations and therapy

• Pain Management

• Texas State and Federal Workers Compensation claims processing

• Free transportation to and from our clinic if necessary

• Workers Compensation Attorney Referral

• Treatment of traumatic injury, stress, occupational disease, and repetitive stress injury. claims

• What We Do

We work together and with our patients to provide a wide variety of services and treatments to rehabilitate injuries, reduce pain, expedite claims processing, and ensure the fastest possible return to every-day activities.

For patients who are seeking treatment for auto injury and workers compensation, our staff offers claims processing as well as communication among lawyers and case managers.

 

Related Topics:

• Texas Employee Rights

• Texas Laws

• Benefits (Compensation)

• If Employer Denies your Claim

• Why Contact IIHC

• FAQs