{"id":223588,"date":"2026-03-27T20:31:10","date_gmt":"2026-03-27T20:31:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-tx\/223588\/"},"modified":"2026-03-27T20:31:10","modified_gmt":"2026-03-27T20:31:10","slug":"fort-worth-first-responders-face-frequent-claim-denials","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-tx\/223588\/","title":{"rendered":"Fort Worth first responders face frequent claim denials"},"content":{"rendered":"<p>            <img loading=\"lazy\" decoding=\"async\" class=\"responsive-image\" src=\"https:\/\/www.newsbeep.com\/us-tx\/wp-content\/uploads\/2026\/03\/1774643469_448_Fort Worth Fire.jpg\"   width=\"1140\" height=\"641\" title=\"Fort Worth firefighters respond to a blaze on Friday, March 13, 2026. Firefighters and police had the most injury claims of any city employees over a two-year span, but a quarter of those were denied.\" alt=\"Fort Worth firefighters respond to a blaze on Friday, March 13, 2026. Firefighters and police had the most injury claims of any city employees over a two-year span, but a quarter of those were denied.\"\/><\/p>\n<p>        Fort Worth firefighters respond to a blaze on Friday, March 13, 2026. Firefighters and police had the most injury claims of any city employees over a two-year span, but a quarter of those were denied.<\/p>\n<p>                Glen E Ellman<\/p>\n<p>Fort Worth police and firefighters, perhaps unsurprisingly, report the highest number of on-the-job injuries of any city workers, but they also rank near the top of the list when it comes to workers\u2019 compensation claim denials.<\/p>\n<p>In fact, nearly every claim denied by the city over a more than two-year span was filed by a police or fire department employee.<\/p>\n<p>A city spokesperson did not respond to a request for comment, but in a previous statement she said Fort Worth \u201cfollows the law and all regulatory guidelines related to injured\/ill workers.\u201d<\/p>\n<p>Records obtained by the Star-Telegram show there were 2,402 workers\u2019 compensation claims filed by city employees between Jan. 1, 2024, and March 17, 2026. More than half \u2014 1,399 \u2014 were filed by police and firefighters, and nearly a quarter of those were denied.<\/p>\n<p>In total, of the 384 workers\u2019 compensation claims that were denied by the city, 341 were filed by police or firefighters.<\/p>\n<p>\u2b50 Our editors also recommend: <\/p>\n<p>Other city departments reporting high numbers of workers\u2019 compensation claims included Parks and Community Services (131 workers\u2019 compensation claims), Transportation and Public Works (97), Water (87), Code Compliance (84), Wastewater (61), Property Management (44), Public Events (25) and Municipal Courts (19).<\/p>\n<p>The denial rate for Parks and Community Service workers\u2019 compensation claims was just over 5%. It was 4% for Transportation and Public Works, 7% for Water, 8% for Code Compliance, 2% for Wastewater, 5% for Property Management, 4% for Public Events and 21% for Municipal Courts (four of 19 claims were denied).<\/p>\n<p>In January, Fort Worth City Council member Charles Lauersdorf <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.star-telegram.com\/news\/local\/fort-worth\/article314349561.html\">took aim<\/a> at Sedgwick, the city\u2019s workers\u2019 compensation claims administrator, over claim denials. At the time, Lauersdorf accused Sedgwick of engaging in \u201cbureaucratic bull&#8212;- that leaves injured firefighters and police officers fighting two battles: one on the job and one at home.\u201d<\/p>\n<p>But there appears to have been the same sort of issues under at least one previous workers\u2019 compensation administrator before Sedgwick.<\/p>\n<p>In 2015, Fort Worth police officer Jody Boday <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.star-telegram.com\/news\/local\/fort-worth\/article10925195.html\">told the Star-Telegram<\/a> it took more than two years and multiple claims denials before she was able to get surgery for a duty injury. The claims administrator at that time was <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.corvel.com\/services\/workers-compensation\/#.VOYcs_nF87c\">CorVel.<\/a><\/p>\n<p>When asked about Boday\u2019s case more than a decade ago, local police and firefighter union leaders said claim denials were commonplace.<\/p>\n<p>A few months after that Star-Telegram story was published, the city replaced CorVel with York Risk Services Group. Sedgwick acquired York in 2019.<\/p>\n<p>Why so many denials for Fort Worth police, firefighters?<\/p>\n<p>Zac Shaffer, president of the <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.iaff440.org\/\">Fort Worth Professional Firefighters Association<\/a>, couldn\u2019t say exactly why the claim denial rate was so much higher for firefighters than other city employees. He and Vice President Skyler Ainesworth mentioned conditions that are covered for first responders that aren\u2019t covered for other employees as perhaps being part of the reason.<\/p>\n<p>By law, first responders have what is called <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.tdi.texas.gov\/wc\/employee\/firstresp.html\">\u201cpresumptive coverage\u201d<\/a> for health conditions and diseases related to the nature of their work. Covered conditions include smallpox, tuberculosis and certain respiratory illnesses, certain types of cancer, heart attack, stroke and post-traumatic stress disorder.<\/p>\n<p>However, Ainesworth said the city almost always denies those types of presumptive claims, at least initially. Ainesworth and Shaffer said it\u2019s because the city has 60 days to approve claims, and that\u2019s often not enough time to validate a presumptive condition. After the 60 days are up, the claim is denied, and the firefighter has to start the process all over again, Shaffer said.<\/p>\n<p>But Shaffer also attributed the denials to the city trying to save money. Workers\u2019 compensation insurance is like any other kind of insurance, he said: the idea is to take in as much money as possible and pay out as little as possible. Shaffer called denials a \u201ccost-containment\u201d strategy.<\/p>\n<p>A previous <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.star-telegram.com\/news\/local\/fort-worth\/article315067828.html\">Star-Telegram report<\/a> revealed police and firefighter claims have been denied because the injured employee sought treatment outside the city\u2019s approved provider network, and Shaffer acknowledged that was a common issue.<\/p>\n<p>That was the case with firefighter Caleb Halvorson, who was injured in September 2025 when a roof collapsed on him while he was battling a residential fire. <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.star-telegram.com\/news\/local\/fort-worth\/article314362650.html\">It took months<\/a> for the city to approve portions of Halvorson\u2019s treatment because he and his family wanted him to use an out-of-network orthopedic surgeon.<\/p>\n<p>Halvorson\u2019s stepfather, Fort Worth firefighter Bobby Cook, previously told the Star-Telegram he believed the city\u2019s approved providers, to a large extent, lacked the expertise to treat Halvorson\u2019s injuries.<\/p>\n<p>Fort Worth police officer Bobbie Sanchez, who was elbowed in the jaw while apprehending a suspect, told the Star-Telegram there was not a single oral surgeon in the city\u2019s network who could treat her injuries, which delayed her recovery.<\/p>\n<p>Lauersdorf told the Star-Telegram earlier this month that first responders shouldn\u2019t necessarily be given special treatment when choosing a provider, but the city\u2019s workers\u2019 compensation administrators needed to understand their injuries are not your typical on-the-job injuries.<\/p>\n<p>\u201cIt should be our goal to get them back to the warrior athlete status they were before their injury in the line of duty,\u201d Lauersdorf wrote in a text message. \u201cThey should certainly have the right to see specialists that deal with specialized injuries, not just your run-of-the-mill provider.\u201d<\/p>\n<p>Is Fort Worth\u2019s medical provider network sufficient?<\/p>\n<p>At first glance, Fort Worth appears to have a robust network of physicians and medical professionals. According to the city\u2019s website, there are approximately 2,300 approved workers\u2019 compensation medical providers in Tarrant County (not counting pharmacists, dentists and radiologists). But when you whittle down that list, removing duplicate names, you\u2019re left with only around 600 providers. And not all of that information is up to date.<\/p>\n<p>For example, on doctor is listed as working at a CareNow clinic in Fort Worth, but that\u2019s not accurate. Another is listed as practicing out of a Concentra clinic in Arlington, but a receptionist at that location couldn\u2019t recall anyone by that name ever working there.<\/p>\n<p>And a chiropractor still shows up on the list even though the clinic he works at, Southwest Sports and Spine, was <a target=\"_blank\" rel=\"Follow nofollow noopener\" href=\"https:\/\/www.star-telegram.com\/news\/local\/fort-worth\/article304955866.html\">dropped<\/a> from the city\u2019s provider network last year. The address associated with the chiropractor on the city\u2019s website is for a clinic that closed years ago.<\/p>\n<p>In a statement previously provided to the Star-Telegram, a city spokesperson said Fort Worth \u201coffers a variety of in-network providers covering numerous practice areas and locations. The city also partners, through direct contracting, with specialized providers if deemed medically necessary.\u201d<\/p>\n<p>The spokesperson did not immediately respond when asked how often the city vets its provider network for accuracy.<\/p>\n<p>                <a href=\"https:\/\/www.star-telegram.com\/profile\/298566418\/\" rel=\"nofollow noopener\" target=\"_blank\"><br \/>\n                        <img decoding=\"async\" class=\"author-thumb\" src=\"https:\/\/www.newsbeep.com\/us-tx\/wp-content\/uploads\/2026\/02\/Matt_Adams.jpeg\" width=\"400\" height=\"400\" alt=\"Profile Image of Matt Adams\" loading=\"lazy\"\/><br \/>\n                    <\/a><\/p>\n<p>                <a class=\"author-name\" href=\"https:\/\/www.star-telegram.com\/profile\/298566418\/\" rel=\"nofollow noopener\" target=\"_blank\">Matt Adams<\/a><\/p>\n<p>                    Fort Worth Star-Telegram<\/p>\n<p>            Matt Adams is a news reporter covering Fort Worth, Tarrant County and surrounding areas. He previously wrote about aviation and travel and enjoys a good weekend road trip. Matt joined the Star-Telegram in January 2025.\n            <\/p>\n","protected":false},"excerpt":{"rendered":"Fort Worth firefighters respond to a blaze on Friday, March 13, 2026. Firefighters and police had the most&hellip;\n","protected":false},"author":2,"featured_media":203407,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[86956,86955,116,118,117,3737,86957,82206],"class_list":["post-223588","post","type-post","status-publish","format-standard","has-post-thumbnail","category-fort-worth","tag-claim-denial-rates","tag-firefighter-workers-comp","tag-fort-worth","tag-fort-worth-headlines","tag-fort-worth-news","tag-fort-worth-police","tag-presumptive-coverage","tag-sedgwick"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/223588","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/comments?post=223588"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/223588\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media\/203407"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media?parent=223588"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/categories?post=223588"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/tags?post=223588"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}