Can TWC deny my claim because I didn't mention pregnancy when filing for light duty restrictions?
I'm in a really tough spot and need advice about my TWC claim! My doctor restricted me to 'light duty' (no pushing/pulling/lifting over 20 pounds) about six weeks ago. When I brought the doctor's note to my warehouse job, HR told me they don't have light duty positions available and put me on unpaid leave until I'm cleared for full duty. I filed for unemployment on March 1st and was completely honest about my situation - told them I have medical restrictions but am ABLE and WILLING to work with those accommodations. Yesterday I finally got a call from TWC, and the agent said, "Your employer reported you've been using their 'maternity sick' absence code, so I'll have to make my determination based on that information." I'm freaking out! Yes, I'm pregnant (5 months along), but my restrictions aren't just pregnancy-related - I have a separate back condition. I never hid my pregnancy, but I didn't specifically mention it because I didn't think it mattered since I CAN WORK with the 20lb restriction! Can TWC deny my benefits because I didn't specifically tell them I'm pregnant? Will they think I was being deceptive? It's been almost 7 weeks with no income and I'm panicking about paying rent.
22 comments
Join the conversation
Cass Green
This is SO typical of TWC to get hung up on technicalities! I had something similar happen (not pregnancy but another medical issue). The key is whether you're available for work - which you ARE with the restriction. Your pregnancy itself isn't relevant to your claim, but how the employer coded your absence might be. Did you request an accommodation in writing before filing?
0 coins
Miranda Singer
•Yes, I requested the accommodation in writing and they responded with a letter saying they don't offer light duty positions. I have all the documentation. I just don't understand why the maternity code matters when I'm medically cleared to work with restrictions!
0 coins
Finley Garrett
You need to make sure TWC understands that you're not claiming benefits due to pregnancy - you're claiming because your employer can't accommodate your doctor's restrictions. Those are two different things! Pregnancy itself isn't usually eligible for regular UI, but being on unpaid leave because of no light duty accommodation IS potentially eligible. Make sure you clarify this distinction in your next communication with TWC. Emphasize that you're able and available for work with the restriction, and that your separation from work is because your employer cannot accommodate, not because you're unable to work entirely. Also, request a copy of your employer's response to your claim so you can see exactly what they're saying about your situation.
0 coins
Miranda Singer
•Thank you, that makes a lot of sense. Should I call TWC to explain this before they make their decision? I'm nervous they'll deny me before I can clear things up.
0 coins
Madison Tipne
u should definitely call them ASAP!!! when i had an issue with my claim last yr the adjudicator was about to deny me until i managed to get thru and explain my side. the problem is getting someone on the phone tho lol
0 coins
Miranda Singer
•I've been trying to call them every day! Either busy signal or 3+ hour wait times and then I get disconnected. It's so frustrating!
0 coins
Holly Lascelles
•Try using Claimyr.com to get through to TWC faster. I was in the same boat trying to reach TWC for weeks about my light duty restriction issue. Claimyr got me connected in about 20 minutes instead of spending hours redialing. They have a video that shows how it works: https://youtu.be/V-IMvH88P1U?si=kNxmh025COIlIzKh Worth it to get this sorted out before a determination is made, because appeals take forever.
0 coins
Malia Ponder
the whole system is BROKEN!!! i got denied because my employer said i "quit" when they told me i had to either work full shifts or not at all with my medical restrictions. fought it for 3 months before i got approved. twc almost always sides with employers first. FIGHT IT if they deny you!!!
0 coins
Kyle Wallace
•This is actually true. I'm a former HR manager, and in Texas, the initial determination often favors the employer, but many workers win on appeal. The key is documenting everything and being very clear about your ability and availability to work. The fact that your employer specifically admitted they don't have light duty work is actually helpful to your case.
0 coins
Ryder Ross
wait im confused why did your employer use a maternity code if you have a back condition? seems like they might be trying to categorize this as pregnancy leave which woudl make it ineligible for UI? maybe?
0 coins
Miranda Singer
•I think they just assumed the light duty was pregnancy-related (which is partly true), but my doctor's note just specifies the 20lb restriction without mentioning pregnancy. I didn't choose the code they used in their system!
0 coins
Kyle Wallace
•This is important - if your doctor's note doesn't specifically mention pregnancy, make sure TWC sees a copy of that note. Also, Texas is an at-will employment state, but they still can't discriminate based on pregnancy. You might want to look into whether this could potentially be a pregnancy discrimination issue as well, since they're coding it as "maternity" when your restrictions are documented as a separate medical issue.
0 coins
Finley Garrett
A few more points that might help your case: 1. Ensure TWC understands you're on unpaid leave due to lack of accommodation, not due to quitting or being fired 2. Specify that you remain able and available for work with your restriction (this is key for UI eligibility) 3. Send TWC a copy of your doctor's note that shows the restriction without mentioning pregnancy 4. Document any jobs you've applied for that would accommodate your restriction (shows you're actively seeking suitable work) 5. When you talk to TWC, use the phrase "constructive discharge" - meaning your employer essentially forced you into unpaid leave by not providing reasonable accommodation Stay persistent! Your case sounds potentially eligible despite the confusion.
0 coins
Miranda Singer
•Thank you so much! I've been applying to jobs that would work with my restriction, so I'll make sure to document that. I finally got through to TWC this morning using the Claimyr service someone recommended, and I explained everything clearly. The agent said they'd add notes to my file before the determination is made. Fingers crossed!
0 coins
Malia Ponder
MAKE SURE you keep requesting payment every 2 weeks even while waiting for a decision!!! biggest mistake i made was stopping my requests while my case was pending
0 coins
Miranda Singer
•Oh wow, I didn't know that! I've been doing the payment requests but wasn't sure if I should keep doing them. Thanks for the tip!
0 coins
Gianni Serpent
My sister had this EXACT same issue last year! Her employer used a maternity code but her restrictions were actually from a prior back injury that got worse during pregnancy. She appealed the initial denial and won. Make sure you're super clear about your ability to work with accommodations!
0 coins
Cass Green
•This is so common. Employers often lump all pregnancy-adjacent issues under "maternity" which creates problems with benefits. The system really doesn't handle these nuanced situations well.
0 coins
Miranda Singer
UPDATE: TWC made their determination today and I was APPROVED! The adjudicator called and said that while pregnancy itself isn't eligible for UI, being put on unpaid leave because my employer couldn't accommodate my medical restriction IS eligible, regardless of what caused the restriction. They also told me that using the "maternity" code was my employer's choice, not mine, so it didn't affect my eligibility. Thank you all for your advice! For anyone else in this situation: be clear about your ability to work with accommodations, keep all your documentation, and don't give up on getting through to TWC to explain your situation clearly.
0 coins
Finley Garrett
•That's fantastic news! I'm glad they made the correct determination. This is actually a good case example that others can reference - the key factor was that you were able and available for work with accommodations, but your employer couldn't provide those accommodations.
0 coins
Cass Green
•So happy for you! When should you expect your first payment? Will they backpay from March 1st?
0 coins
Miranda Singer
•Thanks! They said I should receive all backpay within 3 business days, going back to my first payment request after the waiting week. Such a relief after almost 7 weeks with no income!
0 coins