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Insult to Injury: Texas Workers’ Comp System Denies, Delays Medical Help

Writer Terry Carter has an excellent article in the American Bar Association Journal regarding the decline of the Texas Workers’ Compensation system since the law was fundamentally changed in 1991. If you work in Texas, or care for someone who does, you should read this eye-opening article. You will be shocked to learn that Texas workers have little or no protection against their employers and the workers’ compensation insurance companies that try so hard to deny any on-the-job injury claims.

The purpose of the 1991 law was to remove claimants’ lawyers from the comp system and force the claimants to deal directly with the insurance carriers and their army of lawyers. The law was extraordinarily successful in achieving this goal. I know, because I am one of the lawyers who was kicked out of the system. According to a report generated by the State of Texas shortly before the law was passed, I was ranked number 13 on the list of claimants’ lawyers handling a high volume of workers’ compensation claims. My partner at the time was ranked slightly lower on the list. But after 1991 neither of us ever handled a single case under the revised law.

Please read this article. You will be amazed at what the Texas Legislature and the Supreme Court have done to Texas employees. Here are the opening paragraphs:

As Deputy Sheriff Ed Martin sat by his squad car in a fast-growing pool of his own blood, he called his wife and woke her at 3:30 a.m. He knew he might die from the point-blank shotgun blast that greeted him moments earlier when he knocked on a door for a 911 call in a tiny east Texas town called China.

“It’s pretty bad and I don’t know how it’s gonna turn out,” Martin told his wife as he awaited a helicopter medical evacuation. “Get the kids and meet me at the hospital.”

When they arrived, Martin was on a gurney and covered with a white sheet splotched red. His wife clutched their sleepy 2-year-old daughter to her chest as their sons, 6 and 10, stood at her side.

“I know it was tough for them,” Martin says, retelling the story of that night in June 2006 in the flat monotone of cop-speak. “But I wasn’t sure if I’d make it through surgery and I wanted to at least tell them ‘Hello’ and ‘I love you.’ ”

Doctors say Martin’s life was saved by his ballistic vest and the swift trip to the hospital in Beaumont, near the Gulf Coast and the Louisiana border. But the blast vaporized the skin of his inner arm down to bare muscle and tendons, and tore out the main artery.

A couple of weeks later, Martin got a phone call from an insurance adjuster handling his workers’ compensation claim. He was told the $7,300 helicopter ride was “not medically necessary” and likely would not be covered.

“Not medically necessary,” Martin says, repeating the phrase twice in succession five years after the shooting. “That was my first introduction to those words. And I’ve heard them a lot since then.”

While cops can’t be sure what lurks behind a door on an emergency call, they know the hazards. But Martin could not have foreseen the traps and trauma in store for him as he entered a state workers’ compensation system that was radically overhauled 20 years ago expressly to drive out lawyers representing injured workers, and that has grown ever friendlier to the insurance industry.

Martin, 45, has undergone 11 surgeries to repair his various injuries. He was away from work for two years. Such treatment is built in progressive stages, many of which—like his helicopter evacuation—were initially denied by the insurer and only later approved.

The chain of repeated denials of treatment not only kept him from recovering sooner but also left him with deep, nerve-enveloping scars that today cause sharp tingles he says feel like ants constantly biting his hand.

Bob Kraft

I am a Dallas, Texas lawyer who has had the privilege of helping thousands of clients since 1971 in the areas of Personal Injury law and Social Security Disability.

About This Blog

The title of this blog reflects my attitude toward those government agencies and insurance companies that routinely mistreat injured or disabled people. As a Dallas, Texas lawyer, I've spent more than 45 years trying to help those poor folk, and I have been frustrated daily by the actions of the people on the other side of their claims. (Sorry if I offended you...)

If you find this type of information interesting or helpful, please visit my law firm's main website at You will find many more articles and links. Thank you for your time.

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