Worker’s Compensation Inquiries

Texas Orthopedic and Spine Associates works with employers, workers’ compensation carriers, adjusters, and authorized representatives to coordinate orthopedic and spine care for work-related injuries.

Please note that we do not accept workers’ compensation cases administered by Sedgwick, SORM, or ICW.

Complete the form below, and a member of our team will follow up regarding your inquiry.

Work Comp Requests

Patient Name

Patient Date of Birth

Date of Injury

Patient Employer

Work Comp Carrier Name

Claim Number

Adjuster Name

Adjuster Email

Area of Workplace Injury

Hand & Wrist

Foot & Ankle

Knee, Hip & Shoulder

Neck & Spine

Other

Message or Request Details

Acknowledgment

I certify that I am authorized to submit this inquiry and that the information provided is accurate. I understand that submitting this form does not authorize Texas Orthopedic and Spine Associates to release protected health information. Additional verification, documentation, patient authorization, or payment may be required before my request can be processed or completed.

If you are human, leave this field blank.