Lifetime Medical Care

Texas law provides lifetime medical care for injuries that are covered by Texas Workers Compensation. In other words, if an injury is the result of an accident or illness that has been determined to be “compensable”, then the workers comp insurance company is responsible for all reasonable and necessary medical care for that injury for the rest of the injured worker’s life.

New Injury & Old Injury. What’s The Difference?

According to Texas Workers Comp law, the difference between a new injury and an old injury is simple. Using the following example, we can see two different sets of circumstances – and one that will actually change the status of an injury from new to old.

EXAMPLE 1 – SAME INJURY

A worker suffers an on-the-job knee injury in January. After several months of treatment and perhaps even surgery, the worker feels like he can return to work and is released to full duty in April. Over time, he notices that his knee continues to hurt and even wakes up some mornings with swelling. He may take medication for pain and inflammation, but unfortunately, later that year he finds himself unable to cope and decides he must go back to the doctor. The doctor asks if he has done anything to aggravate the injury or whether he has fallen or twisted his knee or has ever felt a sudden, out-of-the-blue increase in pain and swelling. After thinking about the doctor’s question, he answers saying that he has not experienced any of those things. In this scenario, the injury is considered the same original workers’ comp injury and all reasonable treatment for the injury will be covered by the insurance carrier.

EXAMPLE 2 – NEW INJURY

A worker suffers a back injury while working in January and is taken off of work by her doctor. After a few weeks of therapy and rest, the worker feels like she can return to work with light duty. Her doctor agrees and releases her to work with some limitations, including not lifting over 10 pounds, etc. Her first day back on the job, she notices that her back still hurts, but still… she is able to do the job as long as she follows the doctor’s instructions. The next day after returning to work, she notices that her back hurts more than the day before, but she still wants to give it a try. While at work that day, she bends over to throw something into a waste basket and instantly feels an onset of intense pain, burning and inability to move or walk easily. She notifies her supervisor that she’s sorry, but she feels she just isn’t ready to be working yet and perhaps needs more time at home to recover. According to Texas workers’ comp law, she has suffered a new injury and is not entitled to a whole new set of benefits for the new injury.

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