To Network Or Not To Network (Is there any question?)

Standard

 In 2005, the 79th Texas Legislature passed House Bill (HB) 7, which authorized the use of workers’ compensation health care networks certified by the Texas Department of Insurance (TDI). The TDI has recently come out with report cards comparing network claims with non-network claims.

Findings:When overall medical costs are looked at for the first six months of a claim, non-network claims averaged $2,217.00 and network claims ranged from $2,221.00 to $3,530.00 depending upon the network. The report does not seem to include the additional administrative expenses incurred to run the networks. Only one network was able to have a lower average of lost time from work (Alliance with 14 weeks). Non-network claimant’s missed an average of 19 weeks. While the other networks claimants averaged from 19 to 31 weeks of lost time. Not surprisingly injured workers’ had greater satisfaction with their treating doctor when in non-network care, with 48% satisfaction. While injured workers treated within networks were satisfied with their treating doctor from 46% down to 36% of the time. Non-network providers also got their patients to a higher level of physical function level than any of the networks achieved.

Conclusion: Networks have taken away injured workers ability to control their own treatment. What good has come from providing the insurance companies more control over the medical treatment: Costs are higher; satisfaction is lower; physical function is lower; and they are not getting claimants back to work any sooner. The more we take away our citizens freedoms, the more we lose. Not only do we limit qualified professionals from competing; we open the door for backroom deals to be made, hurting not only the injured worker, but the employers.

If you have any questions call our Dallas office at (214)357-1782.

Disputing Impairment Ratings

Standard

Traditionally, a claimant could dispute their impairment rating by completing a DWC-32 form requesting a designated doctor for maximum medical improvement (MMI) and/or impairment rating (IR). If the rating came from a designated doctor, the claimant had ninety (90) days (from the date of receipt) to fill out a DWC-45, stating that they wished to dispute the MMI and IR. No evidence or even a hearing was required to stop the ninety (90) day window from expiring. With the changes in Rule §141, disputing impairment ratings have become more complicated. Claimant’s can still dispute rating by filling out a request for a designated doctor. However, if the rating is from a designated doctor, the claimant must request a Benefit Review Conference (BRC) by providing a complete DWC-45 disputing the MMI and/or IR. For the form to be considered complete there must be sufficient evidence to support the claimant’s position along with evidence of attempts to resolve the issue prior to requesting the hearing. If the claimant does not submit a complete request, the ninety (90) day window could run thereby eliminating injured workers’ right to dispute the rating. This could result in an injured worker being stuck with an inaccurate IR. If the ninety (90) days has already run, ratings may only be disputed if there is compelling medical evidence meeting one of the statutory exceptions under Texas Labor Code §408.123(f). To dispute MMI and IR, claimant’s legal counsel and treatment provider must coordinate quickly to prepare evidence to protect the claimant’s rights. If you have any questions about disputing an impairment rating call our Dallas office at (214)357-1782.

Disputa por tasa de incapacidad

Standard

Tradicionalmente, los demandantes podían disputar su tasa de discapacidad completando un formulario DWC-32 en el cual solicitaban un médico designado para la máximo mejora médica (MMI) y / o tasa de incapacidad (IR). Si la tasa provenía de un médico designado, el demandante tenía noventa (90) días (a partir de la fecha de recepción) para llenar un formulario DWC-45, que mostrara el interés para disputar el MMI e IR. No se requería pruebas o incluso una audiencia para que el plazo de noventa (90) días expirara. Con los cambios en la Regla §141, disputar una tasa de incapacidad se ha vuelto más complicado. Los demandantes pueden todavía disputar su tasa de incapacidad completando una solicitud de un médico designado. Sin embargo, si la tasa proviene de un médico designado, el reclamante debe solicitar una Conferencia para Revisión de Beneficios (BRC), proporcionando un formulario DWC-45 completo que dispute el MMI y / o IR. Para que el formulario se considere completo debe haber pruebas suficientes que sustenten la posición del demandante junto con la evidencia de sus intentos de resolver el problema previo a solicitar la audiencia. Si el solicitante no presentara una solicitud completa, el plazo de noventa (90) días podría vencer y dejar sin efecto el derecho del trabajador lesionado a disputar la tasa de incapacidad. Esto podría dar lugar a que un trabajador lesionado reciba un IR inexacto. Si el plazo de noventa (90) días ya se ha acabado, las tasa sólo pueden ser impugnadas si hay evidencia médica que obliga al cumplimiento de una de las excepciones legales expuestas en el Código Laboral de Texas §408.123 (f). Para disputar un MMI o IR, tanto el representante legal del demandante como su proveedor de tratamiento médico deben realizar coordinaciones rápidas a fin de preparar pruebas para proteger los derechos del demandante. Si usted tiene alguna pregunta sobre como disputar la tasa por incapacidad llame a nuestra oficina de Dallas al (214) 357-1782.

Applying for Citizenship

Standard

Our office has an immigration attorney who has a great deal of experience in helping clients apply for citizenship. This is something that many permanent residents do not apply for because of many different reasons. The immigration attorney strongly encourages permanent residents to apply for citizenship if they are eligible. If a permanent resident received permanent residence through marriage and has been married to the same person for three years, they are eligible to apply for citizenship after three years. People who received permanent residence through other methods are eligible to apply for citizenship after five years. You have to be at least eighteen years old in order to apply for citizenship. Normally people who apply for citizenship have to pass English and civics testing requirements. There are different testing requirements based on the age and length of permanent residence of the applicant at the time of application. If someone is over 50 years of age and has lived in the U.S. as a lawful permanent resident for at least 20 years, or if someone is 55 years of age and has lived in the U.S. as a lawful permanent resident for at lest 15 years, that person does not have to take the English test but may take the civics test in the language of their choice. Someone who is over 65 years of age and has lived in the U.S. as a lawful permanent resident for at least 20 years does not have to take the English test but has to take a simpler version of the civics test in the language of their choice. Someone who is a lawful permanent resident can always be removed should they commit some offense that makes them removable. Citizens of the U.S. are not subject to removal from the U.S. Call our office at 214-357-1782 and we can help you apply for citizenship. Our e-mail address is info@themorrisfirm.net.

Solicitando la ciudadania

Standard

Nuestra oficina cuenta con un abogado de inmigración que posee gran experiencia en ayudar a los clientes que solicitan ciudadanía. Esto, es algo a lo que muchos residentes permanentes no aplican por muchas y diferentes razones. El abogado de inmigración, alienta firmemente a los residentes permanentes para solicitar la ciudadanía si es que son elegibles. Si un residente permanente recibió la residencia permanente por su matrimonio y ha estado casado con la misma persona durante tres años, son elegibles para solicitar su ciudadanía luego de tres años. Las personas que han recibido la residencia permanente a través de otros métodos son elegibles para solicitar la ciudadanía luego de cinco años. Usted debe tener al menos dieciocho años de edad para poder solicitar la ciudadanía. Normalmente las personas que solicitan la ciudadanía tienen que pasar los requisitos de inglés y educación cívica. Existen diferentes requisitos de prueba que están basados en la edad y la duración de la residencia permanente del solicitante al momento de la solicitud. Si alguien tiene más de 50 años de edad y ha vivido en los EE.UU. como residente permanente legal por lo menos 20 años, o si alguien de más de 55 años de edad y ha vivido en los EE.UU. como residente permanente legal por al menos 15 años, no tienen que tomar el examen de Inglés, pero puede tomar el examen de educación cívica en el idioma que ellos elijan. Alguien que es mayor de 65 años de edad y ha vivido en los EE.UU. como residente permanente legal por lo menos 20 años no tiene que tomar el examen de Inglés, pero debe realizar una versión más simple de la prueba de educación cívica en el idioma que elija. La residencia de un residente permanente legal siempre puede ser removida si es que este comete algún delito que lo haga removible. Los ciudadanos de los EE.UU. no están sujetos a expulsión de los EE.UU. Llame a nuestra oficina al 214-357-1782 y podemos ayudarlo a solicitar la ciudadanía. Nuestra dirección de correo electrónico es info@themorrisfirm.net.