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TWC denied my claim after reapplication due to staph infection - Senator involved but STILL no appeal hearing date

I'm at my wit's end with TWC and don't know what else to do. I got a severe spider bite that developed into a staph infection in my knee. Doctor ordered me to stay off work (I have all the medical documentation). When I couldn't return within their timeframe, my employer terminated me - which should be qualifying for unemployment since it was no fault of my own. Here's where it gets ridiculous: My benefit year expired during recovery, so TWC made me reapply. Suddenly my former employer submitted a bunch of fake write-ups claiming I QUIT (completely false!) and TWC just accepted their side without question. I was denied benefits immediately. I filed an appeal back in MARCH with 25+ pages of evidence including: - Text messages showing I was told not to return - Doctor's orders and medical documentation - Photos of the infection - Phone records proving I tried to communicate with them It's been 7 WEEKS with no appeal hearing date scheduled! I had to contact my state senator who said they're "constantly dealing with TWC" about similar cases. His office got TWC to call me back, but they just said I'm "in the queue" for a hearing. How can they make determinations based only on what the employer claims? Has anyone dealt with this kind of situation where medical documentation is being completely ignored? Did contacting your representatives actually help speed things up?

Mei Lin

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I went through similar BS with TWC last year after a workplace injury. They'll deny ANYBODY if the employer objects - doesn't matter what proof you have. The appeal system is completely backed up right now and has been for months. You did the right thing contacting your senator, but honestly, it probably won't speed things up much. Mine took 11 WEEKS to get scheduled, and I had my state rep involved too. The whole system is RIGGED against workers. They side with employers almost every time initially. Once you get to the actual hearing though, the hearing officers are usually more fair than the initial claim processors. Make sure you have all your evidence ORGANIZED and ready to submit. The hearing notice will have instructions for submitting exhibits beforehand - DO NOT MISS THAT DEADLINE or they might not consider your evidence!!!

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Jamal Wilson

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11 WEEKS?? That's outrageous! I can barely make rent as it is. Did they at least backpay everything once you won your appeal? I have all my evidence organized in a binder with tabs, but I'm scared they'll lose it if I mail it, and not sure if I can submit electronically.

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Liam Fitzgerald

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Sorry you're going through this frustrating situation. TWC appeal hearings are taking 8-10 weeks on average right now. A few things to help your case: 1. Make digital copies of EVERYTHING you submit to TWC 2. When you finally get your hearing notice, it will contain instructions for submitting evidence electronically before the hearing date (usually 48 hours prior) 3. Practice what you'll say during the hearing - be concise and stick to facts 4. If your doctor can provide a letter specifically stating your inability to work was medically necessary, that strengthens your case 5. Be prepared to explain why the employer's write-ups are fraudulent with specific examples If you win your appeal, you'll receive all back payments for eligible weeks. Make sure you continue requesting payment every two weeks even while waiting for the appeal hearing.

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Jamal Wilson

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Thank you for the detailed advice. I've been requesting payment faithfully every two weeks, but they show "$0" because of the denial. My doctor already wrote a letter explaining the infection was serious enough to require bed rest - is that sufficient? Should I get more specific medical documentation?

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GalacticGuru

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This happend to me to!!! employer lied said i was fired for attenance but it was becuase of my carpal tunnel surgerry!!! took 4 months to get a hearng and i won but it was such a nightmere. keep calling TWC every single day!!

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Jamal Wilson

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4 MONTHS??? I might be homeless by then! Did you do your hearing by phone or in person? I'm worried I might mess up if it's by phone.

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Amara Nnamani

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I had a similar problem with the TWC after I broke my ankle last year. Getting through to an actual human was impossible - busy signals, disconnects, automated system loops. I finally tried Claimyr (claimyr.com) and got through to a real agent in about 15 minutes. They helped me understand exactly what medical documentation I needed for my appeal and explained why my case was taking so long to process. Saved me weeks of frustration. They have a video showing how it works: https://youtu.be/V-IMvH88P1U?si=kNxmh025COIlIzKh Might be worth it just to get an update on your appeal status and make sure your documentation is properly submitted.

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GalacticGuru

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does it acutally work? ive been tryng to get thru for 3 weeks!

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Amara Nnamani

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Yes, it worked for me. I was skeptical too but I was desperate after trying to call for weeks. The TWC agent I spoke with was able to see notes on my account that explained why my case was delayed. They also told me exactly what documents were missing from my file that I thought I had already submitted.

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I went through a very similar situation, and here's what I learned: the initial determination is often made very quickly with minimal review, especially when the employer protests. But the appeal hearing officers are much more thorough. Regarding your appeal waiting time: Unfortunately, TWC is severely backlogged with appeals. While contacting your senator was smart, even their influence can only do so much. The best thing you can do while waiting is: 1. Continue requesting payment every two weeks 2. Document any ongoing job search activities (minimum 3 per week) 3. Keep a log of all TWC communications 4. Prepare a timeline of events for your hearing When you do get the hearing notice, it will likely be a phone hearing. You'll receive instructions for submitting evidence beforehand. Make sure any documentation you have is clear and organized chronologically. Based on what you've described, with medical documentation and evidence the employer's claims are false, you have a strong case. The fact your benefit year expired is just unfortunate timing but shouldn't affect the merits of your case.

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Jamal Wilson

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Thank you! This is super helpful. I've been doing my work searches but wasn't logging them since my claim is denied - should I be doing that anyway? Also, do I need a lawyer for the appeal hearing? I can't really afford one but I'm worried about facing my ex-employer alone.

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Ok so this is what u need to do. U HAVE to call TWC like everyday. I was in same boat last year and my appeal took 3 months!!!! but after i called everyday for a week they finally set a date. the trick is getting past the busy signals. u gotta call at like 7:58am right when they open. sometimes I would use 2 phones at once to double my chances lol. just keep calling and dont give up!!!! btw u don't need a lawyer, the appeal hearing people are actually pretty nice and will help u thru it. just make sure ur organized and have all your stuff ready. good luck!!

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Mei Lin

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This is terrible advice! Calling repeatedly doesn't prioritize your case - they schedule appeals in the order received. All you're doing is tying up the phone lines for people with actual questions. The appeal department is completely separate from the call center agents anyway.

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Dylan Cooper

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I went through this exact situation two years ago. The TWC is overwhelmed with appeals right now because so many employers automatically contest unemployment claims. I know it's frustrating, but unfortunately, there's not much you can do to speed up the process. What helped me was preparing a clear, chronological statement for my hearing. The appeals officer will ask you to tell your side first, and having a written statement to read from kept me from getting flustered or forgetting important details. Focus on the facts that prove you didn't quit: - When and how you notified your employer of your medical condition - Documentation showing the doctor ordered you to stay home - Any communication showing the employer terminated you (vs. you quitting) During my hearing, the employer actually admitted they fired me after being questioned by the hearing officer. Sometimes they'll contradict themselves if you let them talk enough. Good luck! The waiting is the hardest part, but if you have good documentation, you have a strong chance of winning.

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Jamal Wilson

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That's good advice about preparing a statement. Did you win your appeal? And if so, did you get all your back benefits paid at once? I'm worried about how I'll pay bills until then.

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Liam Fitzgerald

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One more thing to consider: while waiting for your appeal hearing, you might qualify for emergency assistance programs. Many counties in Texas have short-term rental assistance and utility payment programs. Food banks can also help with groceries to stretch your budget. These resources can help bridge the gap until your appeal is resolved. If you win your appeal, TWC will pay all the back weeks you're eligible for in one lump sum. Just make sure you're submitting your payment requests every two weeks, even while your claim is denied. This creates a record of continued certification that makes the back-payment process much smoother.

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Jamal Wilson

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Thank you for mentioning this. I've been avoiding food banks because I always thought they were for other people who needed them more, but I'm down to eating ramen most days. I'll look into assistance programs in my county.

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GalacticGuru

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btw the hearng will probly be over the phone not in person. thats how mine was. make sure ur in a quite place with good signal so u dont get cut off!!!

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Dylan Cooper

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Good point. Also make sure your phone is charged! My hearing lasted almost an hour.

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Mei Lin

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The real problem is TWC is DESIGNED to side with employers initially. They know most people give up and don't appeal. And they make the appeal process as slow and painful as possible hoping even more people give up. I filed a complaint with the DOL after my case because of how they handled it. Didn't change anything for me personally but maybe if enough people report the issues they'll be forced to improve the system.

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While there are certainly issues with the system, I don't think it's fair to say TWC is designed to side with employers. The initial determination process is just more streamlined and doesn't always allow for thorough review of all evidence. That's precisely why the appeal process exists - to provide a more comprehensive review when needed. The backlog is unfortunate but it's more a result of understaffing than an intentional barrier.

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