Hello, my name is Amanda, and my uncle is a central Texas police officer who was injured in the line of duty. This nightmare began for him after he was knocked off a porch during an arrest in December 2016. The fall resulted in a large cartilage mass being removed from the bone. The damage was surgically repaired via microfracture in early 2017. The recovery was slow, but he was able to return to active duty.

In August of 2019, He exacerbated the 2016 injury while on duty. He followed the guidelines and sought medical attention immediately, which started the Workman's Comp process. Several orthopedic surgeons had the opinion that, given the history of the knee, it was likely that there was an internal issue with the knee that would require surgical intervention to repair the problem

The insurance carrier only wanted to assume responsibility for a sprain which caused my uncle to seek help from an ombudsman (an official appointed to investigate complaints against maladministration) and eventually a worker's comp attorney. The process led to nearly 3 years of litigation, including a worker's comp judge ruling in favor of my uncle, citing several medical issues that were determined to be caused by the work-related injury and exacerbation of the 2017 microfracture.

As I watched my uncle go through this process, it seemed unreal that an insurance carrier would go against a first responder with a bonified on-duty injury and continue to fight through the process even after the judge's ruling. As time progressed, I would learn that the insurance carrier would ultimately bring into question the extent of the injury which started an independent medical review process

The independent medical review was conducted by a 3rd party physician hired and paid for by the insurance carrier to render an opinion based on ODG (official disability guidelines). After all the legal proceedings, over a dozen orthopedic and medical doctors' opinions stated that my uncle's knee was damaged to the extent that he would likely need a total knee replacement. It came down to a single physician referencing ODG guidelines.

The 3rd party physician noted three primary decision factors denying a total knee replacement as recommended by the majority of the orthopedic surgeons my uncle had seen over nearly 3 years. Based on ODG guidelines, my uncle was not yet 50 years old, which was the minimum recommended age for a total knee replacement. The treating physician had not noted my uncle's BMI (body mass index) and the treating physician wanted to perform a computer-aided TRK (total knee replacement). The independent medical review doctor cited that the ODG guidelines had no references to "computer-aided" TKR. Therefore he was denying the request for a total knee being medically necessary.

The Texas Observer did a story speaking on behalf of my uncle and other first responders that have had similar experiences. (see below) I was appalled to see documented cases of first responder families being sued for death benefits from Covid that they contracted in the line of duty and presumptive cancer deaths by third-party insurance carriers.

Over the last 3 years, my uncle went to work in a modified capacity just days after injuring his knee in August of 2019. He is currently not at MMI (maximum medical improvement) and never started temporary income benefits under comp. He is loyal to his family, his agency, and serves his community with integrity. My uncle's attorney scheduled another CCH (contested case hearing) to overturn the independent medical review scheduled to take place in mid-September.

My uncle is a father, a husband, a brother, and a true family man (see photos below). He supports his family and I have seen the devasting effect the injury has had on him. His inability to work extra jobs and overtime has greatly affected his earning potential. My uncle loves the outdoors and my earliest memories of him included outdoor adventures, hiking, biking, etc. It breaks my heart to know that my uncle is not alone in this, as there are other first responders fighting the same battles to receive medical treatment for work-related injuries and illnesses.

After careful consideration, my uncle opted to seek treatment through private insurance. He had his knee replaced on July 29, 2022. He is currently recovering and using his accumulated leave. The co-pays and other medical expenses are straining his financial base.

First responders are vital to our society. It is my hope that this fund will help him with his medical recovery, his mounting medical bills, and his financial losses over the last 3 years.

**Link to Story**

Article link

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https://www.texasobserver.org/workers-comp-texas-lawsuits/?fbclid=IwAR3BTFw9GrZqvXmIgdNk295TisKuqUzElc1gOheiYgltk4g9VUeidSk-v-0