Injured at Work?
A Texas Workers’ Compensation Attorney Can Help Protect Your Rights
Texas is famous for a lot of things, and one of those is the Texan work ethic. The Lone Star State is teeming with industry, and because of the dedication of its workforce and its abundant natural resources — wide open spaces included — Texas reached an astonishing milestone in 2021. Texas now has the ninth largest economy in the world, knocking the entire country of Brazil down a place.
Texas shows no sign of stopping its growth, either, especially with the addition of major employers like Amazon and Tesla joining the family. Texas takes care of its own, but what happens when an injury leaves you feeling like you have been left out in the cold?
What Is Workers’ Compensation?
Workers’ compensation is supposed to provide relief to employees who have been injured while 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 must provide workers’ compensation, such as government agencies; city, county and state employers; and public universities. In addition, building and construction contractors for public employers must provide workers’ comp for their employees, as must transportation carriers who move throughout the state.
Texas employers have two options for workers’ comp coverage:
- Private insurance company
- Self-insurance, if they qualify
When you are injured at work, you will file a claim with workers’ comp, then you expect to be compensated for your medical bills, lost wages and other qualifying expenses. At least, that is the idea most employees have about the program. By law, workers may be eligible for compensation from four different kinds of benefits.
- Income benefits: From temporary to lifetime benefits, these are designed to replace some of the wages lost because of 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.
As a state-regulated program, Texas’ workers’ compensation program is managed by the Division of Workers’ Compensation, which is supposed to ensure that injured employees
- Are treated with dignity and respect
- Have access to a fair resolution process
- Have access to timely, high-quality medical care
- Receive rehabilitation services needed to return to work
Workers’ comp is designed to protect the employer from huge lawsuits while providing the employee, or their family in the event of a fatal injury, compensation for their injury. However, some groups are concerned that states are rolling back their workers’ comp protections in favor of private insurance companies or devaluing or denying claims more often.
Who Is Eligible for a Workers’ Compensation Claim?
Being injured at work does not automatically qualify you to file a workers’ comp claim. In order 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
- Operating a forklift in the warehouse where you work
- Being attacked by a dog while laying fiber optic lines
- Developing carpal tunnel syndrome from typing
Even if you are considered at fault for your injury, it is still covered 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 personally motivated 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
- Workers’ comp appeals must be filed within 30 days of the injury, and you must submit any first appeal within 90 days of the decision.
- You will likely need to seek your medical care from a list of state-approved doctors.
- Workers’ comp may disqualify you from other benefits, or vice versa.
Regardless of whether you believe you were seriously injured, any time you are injured at work, you should immediately take steps to protect yourself — even if you are unsure whether you have a workers’ comp claim.
What’s the Process of Filing for Workers’ Comp?
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.
- 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 file 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 medical care. Depending on the severity of your injury, and whether you were unconscious, this may happen before step 1, and that is okay. Even if you do not think you are seriously hurt, you will need to be seen by a professional for both your own 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 choosing 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 educate you about your options and how to protect your rights as you move forward with your claim.
- 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 in order 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.
Workers’ Comp for Exposure to Viruses and Toxins
The Law Offices of Aaron Allison is not intimidated by tough cases that require complex scientific knowledge. Clean room litigation has become a prominent part of our personal injury and workers’ compensation practice. Hazardous chemicals used in the production of these chips have resulted in a high number of birth defects of children of clean room workers. Our law firm resides in a major center for semiconductor computer chip manufacturing, and our Austin workers’ compensation lawyers have experience in pursuing these complex claims.
Furthermore, in 2020 alone, data reported by the Texas Department of Insurance (TDI) shows that nearly half of all workers’ comp claims for the year involved workers with COVID-19.
- Over 32,000 COVID-19 claims
- 130 fatalities reported
- 49% of claims were denied
- Only 17 disputes filed as of December 6, 2020
Debilitating illness and injury can impact you, your family and even generations to come. If your employer denies your workers’ claim, you can challenge the denial through the DWC. If you cannot solve the dispute through negotiation with the DWC, you can request a workers’ comp court hearing.
How Can a Workers’ Comp Attorney Help Me?
When 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’ comp attorney can provide you the information you need to move forward toward maximizing your recovery.
We have successfully handled cases against some of Texas’s biggest businesses, including H-E-B, Lowe’s, Home Depot and several major healthcare facilities. Since 1978, our law firm has provided honest and competent legal counsel to the injured workers of Austin, and our Austin workers’ compensation team has the experience and resources necessary to work to meet your needs. Contact us today for a free consultation.