Compensation for Injured Workers
The Texas Workers’ Compensation program is an injured worker compensation program managed under the laws of the State of Texas. Texas is one of few states that does not require employers to carry workers compensation. For that reason, not all Texas employers have work injury insurance under the Texas Workers’ Compensation Act. Some employers elect non-subscriber status while others qualify as self-insured employers. Unfortunately, there is yet another possibility and that is that the employer does not have any work injury insurance at all. It’s not illegal or against the law to be running a business and not have any work injury insurance but, not having insurance exposes the employer to liability for injuries that result from company negligence. For this reason, most large and established companies do have insurance through Workers’ Compensation or by, electing non-subscriber status and having a policy or work injury benefit plan that covers work injuries.
According to the Texas Department of Insurance, “Workers’ compensation insurance coverage provides covered employees with income and medical benefits if they sustain a work-related injury or illness. Except as otherwise provided by law; Texas private employers can choose whether or not to provide workers’ compensation insurance coverage for their employees.”
What are the Steps in Opening a Workers’ Compensation Case?
There are certain steps that apply in most work injury scenarios. When you get injured on the job while working for an employer with Workers’ Compensation coverage, you need to make sure you get informed, act quickly and, if you are unable to move your claim along or run into any problems, that you contact an experienced Texas Workers’ Compensation lawyer.
- Report the Incident: If you get injured on the job, the first thing you need to do is report your injury. You do not want to provide any reason for your employer to claim that you were not injured performing your assigned job duties. As long as you report your injury, you should have no issues proving that your injury occurred during the course and scope of your employment.
- Get Medical Attention: If you are injured on the job and you are in pain, you need to make sure you seek medical attention so that your injury can be assessed, and a treatment plan can be provided to you.
- Open the Claim: Once you know the extent of your injury, you will need to contact the right people to get your claim opened with the division of workers compensation. At this point, your wait to see if your employer’s workers compensation insurance has any reasons to deny your claim. Sometimes claims are denied because the insurance claims that at the time of the incident, you were not an “employee” of the specific employer. If your claim is denied, you will want to talk to an experienced Workers’ Compensation lawyer.
- Workers’ Compensation Benefits: Determining what benefits you are entitled to can be difficult. You should know that there are basically the following types of benefits under workers’ compensation: Income benefits (Temporary, impairment, supplemental, lifetime), Medical Benefits, Burial Benefits and Death Benefits. Generally, if your claim is accepted by your employer’s Workers’ Compensation insurance, you will be eligible for reasonable and necessary medical treatment and some income benefits until you recuperate as much as your going to under the care you are receiving (maximum medical improvement).
- Conflicts: Because your benefits are dependent on your injury and the continued need for care, there are times that the insurance may deny your claim because they believe continued medical care is no longer necessary. For this reason, when you hit a wall getting additional medical treatment approved by your employer’s worker’s compensation insurance, it’s crucial that you seek legal advice.
- Maximum Medical Improvement: From the point that a physician has determined that you have recuperated from your injury as much as you are going to (Reached MMI), your benefits are going to change. You will need to be aware that the benefits you may be entitled to will be based on your level of impairment.
Work Injury cases under the Texas Workers’ Compensation program require that the injured worker be vigilant and not fall asleep on your rights. As long as you are injured during the course of scope of your employment, you should receive benefits. The key is knowing what benefits you are actually entitled to receive.
If you’ve been injured on the job and don’t know whether you are entitled to benefits under Texas Worker’s Compensation or, whether your employer is a Texas Non-Subscriber with an Employee Injury Benefit Plan, call Houston Work Injury Attorney Hector L. Sandoval and get the representation that you deserve! Sandoval Law Firm, PLLC helps injured workers. Call (346) 347-7777 for a free and informative consultation!