Texas Workers Compensation Attorney & Laws

Workplace accidents happen every day, with difficult consequences for workers and their families. Accidents and injuries may incur medical costs, lost wages, and other expenses. Workers’ compensation is a specific form of insurance designed to cover these costs and help workers recover and return to work. Texas workers’ compensation law is designed to provide relief to employees who have been injured while on the job. Your Texas workers’ compensation benefits should cover all of your medical and rehabilitative costs.

Although many employees enjoy the benefit of workers’ compensation when they get hurt at work, not all Texas employers carry workers’ compensation insurance, although they may still be entitled to damages. Texas workers’ compensation laws are complex, so here is an overview of what workers need to know.

What are Workers Compensation Laws in Texas?

All public employers in Texas must provide workers’ compensation; these include 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.

However, Texas is the only state that does not require private employers to carry workers’ comp insurance. Private companies can choose to be “non-subscribers,” and carry their own liability insurance or insure themselves. Non-subscribing employers have additional risks, including:

• No legal liability limits. An injured employee who wins a personal injury lawsuit against a non-subscribing employer may recover very high damages without legal limits.
• Loss of defenses. Workers’ comp may deny claims if the injury was due to the employee’s own negligence. However, non-subscribing employers may still be liable in these cases.

If your employer does not carry workers’ compensation insurance, they must notify you and must also file an annual notice with the state.

If you have a work-related illness or injury, and your employer does not have workers’ compensation, you are still entitled to recover damages. In some cases, you may need to file a personal injury lawsuit in order to recover your medical costs and lost wages. It is best to consult with a workers’ compensation attorney, even if your employer does not carry workers’ comp, in order to understand your rights.

What Types of Injuries Are Eligible for Workers’ Compensation in Texas?

All work-related injuries are eligible for workers’ compensation, provided the employee was behaving safely and performing their duties as assigned. Some common types of injuries covered by workers’ compensation include:

• Broken bones
• Sprains and strains
• Neck and back injuries
• Repetitive stress injuries
• Shoulder or knee injuries
• Burns
• Toxic exposure
• Brain injury
• Amputation
• Death

Other common workplace injuries include hearing loss, foot problems, and cuts and lacerations.

What Kind of Benefits Does Workers’ Compensation Pay?

By law, workers may be eligible for compensation from four different kinds of benefits:

1. Income benefits: From temporary to lifetime benefits, these are designed to replace some of the wages lost because of your injury.
2. Medical benefits: These cover “reasonable and necessary medical care” for your injury.
3. Burial benefits: Fatal injuries qualify for compensation to help cover the costs of funeral expenses.
4. Death benefits: Families may qualify for death benefits when their loved one dies from a work-related injury.

Who Is Eligible for a Workers’ Compensation Claim?

Being injured at work does not automatically qualify you to file a workers’ compensation claim. In order to be eligible for a claim, your injury or illness must directly result from the “course and scope” of employment. As an example, you might have a valid workers’ compensation claim for developing carpal tunnel syndrome from typing, or for receiving a back injury while working on a ladder.

Hazardous or toxic work environments are another example of potential workers’ compensation claims. For instance, cleanroom 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 cleanroom workers. Our law firm resides in a major center for semiconductor computer chip manufacturing, and our Texas workers’ compensation lawyers have experience in pursuing these complex claims.

Even if you are considered at fault for your injury, your workers’ compensation claim may be covered. There are, however, some exceptions: just a few examples entail being engaged in a criminal act, intoxicated, or participating in an off-duty recreational activity. Additionally, certain farm and ranch workers, casual laborers, domestic workers, and any worker covered by a method of compensation established under federal law may be exempt from receiving Texas workers’ compensation benefits.

What is the Workers’ Compensation Process in Texas?

First and foremost, if you are injured on the job, you need to report your injury to your employer as soon as it occurs—even if you think someone else already has. You can lose your rights to workers’ compensation 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.

Generally, a workers’ compensation appeal must be filed within 30 days of the injury, and you must submit any first appeal within 90 days of the decision. If your employer denies your workers’ claim, you can challenge the denial through the Department of Workers Compensation. If you cannot solve the dispute through negotiation with the DWC, you can request a workers’ comp court hearing.

You should also seek prompt medical care. You will likely need to seek your medical care from a list of state-approved doctors. 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.

Sometimes, workers’ compensation 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’ compensation cases are medical disputes and indemnity disputes. A medical dispute occurs where a state-approved doctor denies care that you believe you need in order to improve, such as surgery, rehabilitation, or other forms of medical treatments. A claim dispute happens when you receive notice that your benefits have been denied, or that you are being provided with insufficient benefits. In these situations, an experienced attorney who is well-versed in workers’ compensation law can help bring an effective claim against the opposing parties.

Temporary workers’ compensation benefits can be collected in Texas for 104 weeks, with a possible extension if you have or will have spinal surgery within 12 weeks prior to the deadline. If your impairment income benefits run out under Texas workers’ compensation, then you may be able to receive supplemental income benefits, providing you meet a number of qualifications.

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 claim to Texas workers’ compensation benefits. A Texas workers’ compensation lawyer can educate you about your options and how to protect your rights as you move forward with your claim.

Can I Appeal a Workers’ Compensation Claim Denial?

If your workers’ compensation claim has been denied, you may feel like you are out of options. However, you can appeal a denied claim, and you should: nearly two-thirds of workers’ compensation appeals are successful and result in paid claims. If your claim has been denied, consult with a Texas workers’ compensation attorney to understand why your claim was denied and how to appeal successfully.

After you have appealed an initial denial, there are several steps to the workers’ comp dispute process, including:

• A Benefit Review Conference (BRC): This is an informal meeting where you and your attorney meet with someone from the insurance carrier and a benefit review officer to discuss your case and try to reach an agreement.
• A Contested Case Hearing: At a contested case hearing, you and your attorney, along with witnesses, give evidence under oath before an administrative law judge. The judge reviews the evidence and makes a ruling.
• Go before the Appeals Panel: If you don’t agree with the results of the contested case hearing, you can go before the appeals panel. The appeals panel will review the evidence and change or uphold the results of the hearing.
• Request a judicial review. If necessary, you can contest the results of your appeal in district court with a judicial review.

Every step in the appeals process requires various forms and paperwork within strict time limits. It is critical to have a qualified Austin workers’ compensation lawyer at your side to win your case and recover your damages.

How Can Aaron Allison Help?

If you or someone you love has been injured in a workplace accident, our experienced Texas workers’ compensation attorneys can help. We know that injured workers often fight an uphill battle to receive the benefits they are entitled to receive by law. Contact the Law Offices of Aaron Allison at (512) 881-7855 or fill out our confidential contact form for a free initial consultation. We can help you obtain the money you need after a serious workplace accident.