Should I Use An Ombudsman For My Texas Workers' Compensation Claim?

Frustrated With Your Ombudsman?
You're Not Alone

Texas Office of Injured Employee Counsel (OIEC)

*** NOTE ***:  THE OIEC IS NOT LEGAL AID.

The Office of Injured Employee Counsel is a state office that exists to help injured workers who are not represented by a licensed Workers’ Comp Attorney. The OIEC is staffed by employees called “Ombudsmen” who are assigned as case workers for injured employees.

What Is The Ombudsman’s Job?

It’s important to remember that an ombudsman is not a licensed attorney. The ombudsman is simply a state employee whose job it is to help you know and understand the workers’ compensation rules and procedures, and to assist with filing forms.

Remember: if you are obtaining help from an ombudsman with your Texas Workers’ Compensation case, you are literally representing yourself.

The Ombudsman Cannot Give You Any Advice, Whatsoever

Remember: if you are obtaining help from an ombudsman, you are literally representing yourself. The Office of Independent Employee Counsel website says it best:

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The adjuster won't return my phone calls or emails. Even the ombudsman they assigned to me has only talked to me like twice, and I feel like they just want me to go away! I really need some advice.
~ RF, Prospective Client
July 2021

Things The Ombudsman CAN Do For Your Workers Comp Case

The OIEC website lists things that an ombudsman can do to help with your workers’ comp case as follows:

  • Answer questions you have regarding your dispute
    • Remember: The ombudsman cannot “guide” you or “advise” you in your case. When it comes to helping you know how to proceed, the ombudsman can only answer questions about the rules, inform you of the process, and instruct you on procedures and policies of conferences and hearings.
  • Communicate with your employer, insurance carrier, and doctor
    • Remember: The ombudsman can only communicate with other parties to gather records and learn information. The ombudsman cannot speak on your behalf.
  • Gather information and documentation to try to resolve the dispute in your claim
    • Remember: The ombudsman cannot “try to resolve the dispute in your claim”. That’s just tricky wording. Notice it says here they can “gather information and documents”, but it is YOUR responsibility to then use that information and those documents so that YOU can resolve the dispute in your claim on your own.
  • Provide you with information that may help you make decisions
    • Remember: This is just restating the items, above. “Providing you with information that may help YOU make decisions” says it all.
  • Give you information about the Division of Workers’ Compensation (DWC) hearings process
    • Remember: Again, this simply re-states what they’ve already said.
  • Prepare you for proceedings and attend them with you.
    • Remember: It’s true that the ombudsman may attend your conferences and hearings with you. However, they are there ONLY to provide you with information about HOW the process works.

Things The Ombudsman CANNOT Do For Your Workers Comp Case

From the Texas OIEC Agreement Itself

When an injured worker agrees to use the services of an ombudsman, he or she must first sign an Agreement that clearly stipulates that the ombudsman is not allowed to give advice, and will not give any advice. (Source: Office Of Injured Employee Counsel Assistance Request)

I know and clearly understand that the Ombudsman:

  • is an employee of the Office of Injured Employee Counsel.
  • is not acting as an attorney nor performing services of an attorney.
  • will not be representing me as an attorney or in any other capacity.
  • will be assisting me to present my claim for benefits.
  • provides assistance at no charge to unrepresented persons requesting assistance.
  • cannot and will not provide legal advice.
  • cannot and will not make or sign any agreements for me.
  • cannot and will not make any decisions for me.
I recently received a MMI for my shoulder but the insurance company in the same letter stated that my neck injury was not due to work and they're just not going to accept it.  I have an ombudsman but he sounds like he's giving up. I'm lost!
~ DH - Prospective Client, August 2021
My Ombudsman at DWC seems like she works for the insurance company! It's been more than 6 months since my BRC, and I finally got the ombudsman to call two days ago!  Then, she called the adjuster and THEY decided together that I'm the one that needs to talk to the adjuster. That's why I went to the OIEC in the first place! I need help please!!
~ BV, Prospective Client
March 2020
I was injured at work and the company doctor gave me a 0% disability. Now my OIEC ombudsman says she cannot help me file a dispute because my employer isn't giving us information that we need.
~ CF, Prospective Client
October 2021
My husband is on worker’s compensation and he has an ombudsman. He isn’t happy with the ombudsman and we haven’t been able to get her to return our calls. Can we get an attorney and tell the ombudsman that we no longer need her assistance?
~ Jane, Prospective Client
May 2021

Tired of Getting The Runaround?

Although there are certain situations where an ombudsman can be of service and assistance, if you are using the OIEC you are still representing yourself. The ombudsman 1) cannot negotiate on your behalf or make demands, 2) cannot give you any advice whatsoever beyond telling you how the rules and policies work, 3) cannot represent you in a hearing, 4) cannot cross-examine the insurance company or company doctor in a hearing, 5) cannot draft or file pleadings on your behalf, and 6) shares no liability in the event mistakes are made and your case is damaged because of missed deadlines, lost opportunities, or other pitfalls that may present themselves during your workers’ comp claim.

Don’t Let Them Fool You Into Not Hiring An Attorney

The Office of Injured Employee Counsel is a government agency, administrated and staffed by government employees. An Ombudsman is underpaid, overworked, and not equipped to adequately and reasonably handle their (often) high caseloads. Every day, injured workers report that it’s hard to get their ombudsman to return their calls. We’ve even heard credible reports of ombudsmen missing deadlines and (illegally) giving bad legal advice.

Nothing can take the place of an experienced, seasoned workers’ compensation attorney who knows and understands the law, can advocate and negotiate on your behalf for your best interests in your workers’ comp claim. Don’t wait. Call us at 713-223-1234 today.

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