Injured Worker FAQs
- I've been injured; help me understand the process.
- What if my first visit was at an emergency room?
- Who manages my care?
- What is the role of the adjuster?
- How do I find out who my adjuster is?
- I am recently injured and need to find a provider.
- Can I go to my current primary care doctor if I'm injured on the job?
- I want to change my doctor, how can I do that?
- What if the doctor I want to go to is further than 30 miles from where I live?
What if my first visit was at an emergency room?
If your first visit after your injury was to an emergency room, and you require additional treatment, you need to select a primary care (Treating Doctor) that can develop a treatment plan. You can see any primary care doctor that is contracted with the Alliance.
To find a Treating Doctor in your area, search our directory.
Who manages my care?
Your Treating Doctor will manage your treatment plan, make referrals to specialists as necessary, and work with your employer on a return-to-work plan as soon as it is safe to do so.
What is the role of the adjuster?
Workers’ Compensation only covers injuries and illnesses that happen in the course and scope of work-related duties. Injuries or illnesses that occur off-duty, or those that are just part of the normal aging process, would be covered under other insurance, such as your group health coverage. The adjuster’s job is to receive and organize all the documents related to the injury/illness to verify that it was work-related.
If the claim is accepted under workers' compensation, the adjuster reviews all the medical bills, makes sure they are for treatment related to this injury, and issues payments. If your injury or illness requires you to be off work for an extended period of time, the adjuster also makes sure that your indemnity payments are processed on time. Throughout the entire process, the adjuster communicates with all parties involved—you, your doctor, and your employer—to support your return to work as soon as it's safe to do so.
What is an indemnity payment?
Workers' Compensation indemnity benefits compensate an employee for lost wages due to an on-the-job injury or illness that prevents him or her from returning to work, on a temporary or permanent basis
How do I find out who my adjuster is?
To find your adjuster you will need to know which pool provides workers' compensation coverage for your employer. If these contacts don't ring a bell, please contact your HR department with your employer. You will also need your claim number when calling the pool.
- Texas Municipal League (TMLIRP): 800-537-6655
- Texas Association of School Boards (TASBRMF): 800-482-7276
- Texas Association of Counties Risk Management Pool (TAC RMP): 800-752-6301
- Texas Water Conservation Association Risk Management Fund (TWCARMF): 800-580-8922
- Texas Council Risk Management Fund (TCRMF): 800-580-6467
Can I go to my current primary care doctor if I'm injured on the job?
You can go to any primary care doctor that is contracted with the Alliance. It's important to note that some family practice doctors or general practitioners do not accept workers’ compensation. So, check the directory before you make an appointment. You can search for your primary care doctor by name using the provider directory.
I want to change my doctor, how can I do that?
Please contact your adjuster regarding changing doctors. If you don't know who your adjuster is, please have your claim number handy when you contact the risk pool.
What if the doctor I want to go to is further than 30 miles from where I live?
If there are no contracted doctors available within 30 miles, talk to your adjuster to see if mileage can be reimbursed. However, if there is a contracted doctor within 30 miles, then mileage will not be paid to see a different provider that is further than 30 miles away from your place of business.