If someone were to have a worker's compensation claim in Texas that had been approved but unpaid, can the medical provider legally file a claim against the injured?

More specifically, the employer paid the hospital bill but did not pay the physician bill - which has now gone to collections.

It appears that SEC. 413.042. PRIVATE CLAIMS; ADMINISTRATIVE VIOLATION of the Texas Labor Code, Title 5 - Workers' Compensation Act prohibits this.


It depends under that law on whether the claim was finally adjudicated not compensable, or the employee violated §408.022 without the doctor's knowledge. The most relevant part of that section is that the employee must "receive medical treatment from a doctor chosen from a list of doctors approved by the commissioner", except in an emergency. If all parties were properly notified that this is a workman's comp case etc. and the employees selection of doctor is not illegal, then the doctor cannot pursue a claim against the employee.

  • That really sounds like the healthcare provider is being shafted here when both the employee and employer are refusing to pay the bill...
    – user28517
    Jan 30 '20 at 1:19
  • No, it means that the employee is not the person who is responsible, if the employer refuses to pay.
    – user6726
    Jan 30 '20 at 1:50
  • Which sucks if there is a dispute that the healthcare provider has utterly no business being part of - it rendered a service, it should get paid. So a worker can get injured, and open a claim and the healthcare service is stiffed for the cost of providing the service for as long as that claim is open. This indicates the healthcare system is broken here, and this law is nothing but a bandaid on the real issue.
    – user28517
    Jan 30 '20 at 2:01
  • Thanks for the response - I think I had the correct understanding then. In regards to payment, the bill is in the process of being paid by my employer, however, I'm trying to mitigate the effect that it has on my credit as it shouldn't have been billed to me in the first place.
    – Daniel
    Jan 30 '20 at 2:21

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