Houston is on track to add 100,000 people and 75,000 jobs in 2022, with a robust recovery from the pandemic. Most of those jobs will be in the services, professional, and healthcare sectors, as we bounce back into a new era.
While we usually think of workplace accidents and injuries in relation to manual labor, many offices, and professional settings can also be a cause of workplace injuries and workers’ comp claims in Texas. Both acute injuries, like slip and fall accidents, and repetitive injuries, like carpal tunnel disease, can result from seemingly safe office environments, and it’s more common than you think.
If you’ve received an on-the-job injury, you may be entitled to compensation. Most workers are protected by workers’ compensation insurance, but unprotected employees may need to pursue legal action to recover their losses in a civil case.
What Is Workers’ Compensation?
Workers’ compensation is a form of insurance that provides relief to employees who have been injured on the job. Texas is the only state that allows private employers to choose if they will cover their employees under workers’ compensation insurance.
All public employers in Texas, such as government agencies; city, county, and state employers; and public universities, must provide workers’ compensation insurance. Building and construction contractors who work for public employers must also provide workers’ comp for their employees, as must transportation carriers who move throughout the state.
As a state-regulated program, Texas’ workers’ compensation program is managed by the Division of Workers’ Compensation in the Texas Department of Insurance, which works to ensure that injured employees:
- Are treated with dignity and respect
- Have access to timely, high-quality medical care
- Receive rehabilitation services needed to return to work
- Have access to a fair claim resolution process
Workers’ comp is designed to protect the employer from liability lawsuits while providing the employee, or their family in the event of a fatal injury, compensation for their injury.
Because Texas workers’ comp insurance is voluntary, non-subscribing employers have additional liability and regulations. Texas workers’ compensation laws are complex, and Aaron Allison is one of the few Houston workers’ comp lawyers who specializes in this challenging field.
Who Is Eligible for a Workers’ Compensation Claim?
Being injured at work does not automatically qualify you to file a workers’ comp claim. To be eligible for a claim, your injury or illness must directly result from the “course and scope” of employment. Some examples of this are:
Even if you are considered at fault for your injury, it may still be eligible for workers’ comp as long as:
- You were not horseplaying
- You were not engaged in a criminal act
- You were not intoxicated
- You did not injure yourself
- You were not participating in an off-duty recreational activity
- You were not the victim of someone else’s criminal act directed specifically at you
- You were not the victim of an Act-of-God incident
A few other important things to know about workers’ comp claims in Texas are that:
- You will likely need to seek your medical care from a list of state-approved doctors.
- Workers’ comp claims must be filed within 30 days of the injury, and you must submit any first appeal within 90 days of the decision.
- Workers’ comp may disqualify you from other benefits, or vice versa.
Any time you are injured at work, even if you believe your injury was minor, you should immediately take steps to protect yourself.
What’s the Process of Filing for Workers’ Comp?
If you or a loved one have been injured at the job site or have been the victim of a fatal accident, worker’s comp provides four different types of benefits:
- Income benefits: From temporary to lifetime benefits, these are designed to replace some of the wages lost due to your injury.
- Medical benefits: These cover “reasonable and necessary medical care” for your injury.
- Burial benefits: Fatal injuries qualify for compensation to help cover the costs of funeral expenses.
- Death benefits: Families may qualify for death benefits when their loved one dies from a work-related injury.
To file for a workers’ comp claim without risking your benefits, you will want to make sure you follow the rules of the state’s labor laws. The four steps include:
- Report your injury immediately. As soon as your injury occurs, you need to report it to your employer, even if you think someone else already has. You can lose your rights to workers’ comp if you do not report the incident within the 30-day deadline, so it’s extremely important to be prompt. You do not have to file paperwork to report your injury, but you should make sure to document the day you reported your injury and to whom.
- Get appropriate medical care. Depending on the severity of your injury, and whether you were unconscious, this may happen before you make a report. Even if you do not think you are seriously hurt, you will need to be seen by a professional for both your safety and for the documentation in your case. Some injuries take time to appear, and it always looks better that you took steps immediately to care for your health. Even if you must see a state-approved doctor, see one of your choice if you can.
- Call an attorney. Again, even if you do not think you need an attorney, call one. An Austin workers’ compensation lawyer can explain your rights and options, and be at your side as you file a workers’ comp claim, negotiate a settlement, or pursue a personal injury or wrongful death lawsuit. Depending on your case, you have a variety of legal avenues available to you, and consulting with an attorney is the best way to ensure your rights are protected.
- File your claim. In Texas, you have one year from the time of your injury to file a workers’ comp claim. Make sure that you see your claim confirmed as received, and document the date you filed your claim.
Sometimes, workers’ comp claims are resolved quickly and to everyone’s benefit. Other times, the insurer will fall far short of what seems fair considering the extent of your injuries. The two most common types of disputes in workers’ comp cases are medical disputes and indemnity disputes:
- Medical disputes: In these situations, the state-approved doctor may deny care you believe you need to improve, such as surgery, rehabilitation, or other forms of medical treatments.
- Claim disputes: Notice of denied or insufficient workers’ comp benefits can be a blow to your peace of mind. Your family may be relying on these benefits as you recover or learn to live with your permanent disability.
How Can a Houston Workers’ Comp Attorney Help Me?
If you believe your workers’ comp case has been unfairly decided, or if your employer does not have workers’ comp coverage at all, speaking with a workers’ compensation attorney Houston can provide you the information you need to move forward toward maximizing your recovery.
Since 1978, our law firm has provided honest and competent legal counsel to the injured workers of Texas, and our Houston workers’ compensation lawyer has the experience and resources necessary to meet your needs, no matter what type of legal options are open to you. Contact us today for a free consultation.