Texas Workers Comp Network Sample QI Report
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How to fill out Texas Workers Comp Network Sample QI Report?
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FAQ
The impairment rating is a percentage that represents the extent of a whole person impairment of the employee, based on the organ or body function affected by a covered illness or illnesses.
You'll choose a treating doctor from the network's provider list. Your treating doctor will oversee the care for your work injury. If your regular health plan is with a health maintenance organization (HMO), you can ask the network to let you use your primary care physician (PCP) as your treating doctor.
If you opt in the network, that means your employees must see a network provider if they are injured on the job. If employers choose the out-of-network option, your injured employees can seek treatment from the WorkWell, TX network or any doctor who will treat them under the Texas Workers' Compensation rules.
Texas law doesn't consider alternative policies and coverage bought from unlicensed insurance companies as workers' compensation. This means you lose your legal protection against lawsuits, and an injured employee could sue you for damages resulting from a work-related injury.
Based on this, your doctor assigns you an impairment rating of 25 for your hand and 10 for your back. This means that your hand has a permanent impairment of 25% and your back has a permanent impairment of 10%. The higher your impairment rating, the less function you'll have in that part of your body.
Generally, the Workers' Compensation Act provides that an injured worker must treat with panel physicians chosen by the employer within the first 90 days of being injured. This is often referred to as the ?90 day rule.? With the passage of Act 57 in 1996, Section 306(f.
Injured workers in Texas are eligible for temporary income benefits when they have lost money from a job for more than seven days due to a work-related injury. Those days do not have to be in the same week or consecutive. Temporary benefits amount to 70 or 75% of what the worker's average weekly wage before the injury.
It states that Temporary Income Benefits, Impairment Income Benefits, and Supplemental Income Benefits can only be paid out to injured employees for 401 weeks (or roughly 7.5 years) from the date of the injury. While this may seem like an adequate amount of time, it can be a lot shorter than you think.