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The Deadline That Can Wipe Out a Workers' Compensation Claim

September 14, 2019

I've been practicing workers' compensation  in Abilene, Texas for several years, now. One of the hardest things that I have to do is occasionally tell people who have serious injuries that have not been treated, and whose weekly benefits have suddenly terminated, that I can't take their case because there is nothing I can do to help them. The reason? They came to me too late, after a critical deadline in their case had passed.

 

Workers' compensation claims are filled with different types of deadlines. There are deadlines to notify your employer, deadlines to get your claim on file, deadlines to respond to denials for medical treatment. The list goes on and on. Usually, when you miss a deadline, there are consequences to it, but those consequences don't effectively end the entire claim. You can continue to receive benefits. But there is one deadline that - if missed - can put you in a position where your benefits are suddenly terminated, and you are left with no options to change your situation,

 

This deadline comes when you first learn that you have been certified to be at maximum medical improvement, and are assigned an impairment rating. Now, impairment ratings themselves are important. I will talk about them in another email. But the deadline that is imposed after you get the impairment rating is serious - and you need to pay attention to it.

 

Once you receive word that you have been placed at maximum medical improvement, consider yourself to have 90 days to (a) determine whether you really are at maximum medical improvement, (b) determine whether your impairment rating is high enough, and - if you aren't satisfied with either of those answers - to take action. In truth, you may have a little more time. The insurance company has to be ready to prove that you received written notice of the impairment rating, but don't worry - they know exactly what they are doing and, if you haven't already, you can count on getting a letter in the mail within the next few days that satisfies their obligation.

 

The clock is ticking, and you need to act fast. If your treating doctor didn't give you the impairment rating, talk to your treating doctor about it. If your treating doctor won't help (sometimes they don't even want to treat you any longer at this stage - they know they probably won't be paid for it - then you probably need other help.

 

Your best option at this point is to seek representation from an experienced workers' compensation attorney. This will cost you a portion of your benefits, which are used to pay your attorney fees, but you will often be much better off, because the attorney may be in a position to extend the period of time that those benefits are paid much farther into the future.

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