Understanding the 90 Day Rule in Texas Workers' Compensation

Workers' compensation laws are in place to protect employees who suffer work-related injuries or illnesses. In Texas, there is a specific rule known as the 90-day rule that applies to impairment ratings given to injured workers. Understanding this rule is crucial for both employers and employees involved in workers' compensation claims.

What is the 90 Day Rule?

The 90-day rule in Texas workers' compensation refers to the timeframe within which an impairment rating given to an injured worker becomes final if it is not disputed. According to this rule, the first valid impairment rating provided to an injured worker becomes final if it is not disputed within ninety days of receiving written notice through verifiable means.

It is important to note that the 90-day period starts from the date the injured worker receives a copy of the impairment rating. This means that the injured worker has ninety days to review the rating and decide whether or not to dispute it.

The Implications of the 90 Day Rule

Once the 90-day period has passed without a dispute, the impairment rating becomes final. This means that it cannot be changed or contested in the future, unless there are exceptional circumstances that warrant a modification.

For injured workers, this rule emphasizes the importance of promptly reviewing and understanding their impairment rating. Failing to dispute an inaccurate or unfair rating within the 90-day timeframe could result in accepting a final rating that may not accurately reflect the extent of their injury or disability.

Employers and insurance carriers also need to be aware of the 90-day rule. It is their responsibility to ensure that the injured worker receives a copy of the impairment rating in a timely manner. Failing to provide this notification within the required timeframe could potentially impact the finality of the rating.

Disputing an Impairment Rating

If an injured worker believes that their impairment rating is incorrect or unfair, they have the right to dispute it within the 90-day period. Disputes can be filed with the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC).

It is important to gather all relevant medical records and supporting documentation to strengthen the dispute. Seeking legal advice from an experienced workers' compensation attorney can also be beneficial in navigating the dispute process and ensuring the injured worker's rights are protected.

Conclusion

The 90-day rule in Texas workers' compensation is a crucial aspect of the claims process. It establishes a timeframe within which an impairment rating becomes final if it is not disputed. Both injured workers and employers need to be aware of this rule and its implications to ensure fair and accurate assessments of work-related injuries and disabilities.