GQ Corner
Q: Are lump sum settlements allowed in Texas and, if so, under what circumstances and for what types of benefits?
A: Generally, settlements have been outlawed in Texas since 1991. There certainly is no way to settle out medical benefits. An injured worker is entitled to medical benefits for life in Texas, provided they can establish the treatment is medically necessary and related to the compensable injury. The parties can settle out indemnity benefits under very limited circumstances (I generally work on a settlement about once every three or four years, so they are very rare). The parties can only settle out indemnity benefits once the claimant reaches eligibility for supplemental income benefits, and even then, the Division of Workers’ Compensation must approve the settlement, and they will only do so if they find the settlement is in the claimant’s best interests. Frequently, a claimant will agree to the terms of the settlement, and the DWC will still reject the settlement under the belief that it is not in the claimant’s best interest.
Q: We have a claimant allegedly injured on the job 08/18/16. He continues to work with restrictions at full pay. The claimant refused to provide a recorded statement or answer any questions. He stated we needed to speak with his wife. The claimant’s wife says she has Power of Attorney. We requested that she send documentation, but nothing has been received to date.
How does this play out in the workers’ compensation arena? He has the ability to work a full time job on an assembly line making auto parts, but he will not tell us what happened or when it happened or what was injured. If the wife has Power of Attorney, does this prevent the claimant from talking to us about his claim? How can the wife answer the necessary questions if she was not present at the time of the injury?
A: The power of attorney has no particular application to a WC case, it only provides the wife the authority to act on his behalf. You still have the right and duty to investigate the case by direct interview with the claimant.
Q: If the employer gives the employee money for a phone allowance, would this need to be included on the DWC 3 under non pecuniary benefit information? The phone is used for business and personal matters and the employee pays the bill, but the employer gives each employee a certain amount of money monthly to use towards the payment.
A: This sounds like a benefit that should be included on the wage statement if it was given in the 13 weeks prior to the date of injury.
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