Workers Compensation in Texas

You aren’t alone if you wonder how workers comp works. Workers’ compensation is a type of insurance that provides wage and medical benefits to people who have become ill or injured while at work. The extent of workers’ comp coverage an employer is required to carry is governed by Texas state law. Thus, in trying to figure out how workers comp works, it helps to understand the laws on the books in the state where the business operates. If the injury or illness a worker sustains is eligible for compensation, the insurance carrier should help ease the financial burden the illness or injury created on the worker. Learn some of the basic principles of Texas workers’ compensation insurance and how the process works.

Workers Compensation Statistics in Texas?

The Texas Department of Insurance reports that the industry with the most non-fatal work-related injuries is retail. Closely following, are the health care, food service, and manufacturing industries. The majority of fatal work injuries occur in the trade, transportation, utilities, and construction industries. The most common workplace injuries are sprain, strains, and tears, cuts, and fractures. In addition, work injuries in Texas are most often caused by contact with equipment, falls, or and overexertion. 30% of injuries cause the employee to miss more than 30 days of work.

How Does Workers Comp Work in Texas?

There is a standard practice to follow when going through the Texas workers’ compensation process. Unfortunately, it begins with you getting sick or injured on the job. The circumstances surrounding the incident that led to the injury are especially crucial. The injury had to occur during the course of your regular work duties. It could also occur while you were performing a special task at the request of your boss. 

Texas does not require most employers to carry workers compensation insurance. Exceptions include government employers, certain construction contractors, motor carriers, and propane or natural gas dealers. All medical expenses for work injuries are covered, as long as they are recommended or approved by your doctor. With the exception of emergency treatment, your doctor must be on the list of approved providers approved by the Texas Workers’ Compensation Commission.

If you will miss more than a week of work, you are also eligible to receive compensation for lost wages. Per the Texas Department of Insurance, Texas applies a formula that pays 70% of the difference between your average weekly wage and the wage you are able to earn post-injury. For employees who make less than $10 per hour, the percentage changes to 75%. Regardless of the actual wages, the minimum weekly benefit is $146, and the maximum is $1007, updated yearly.

The steps you take immediately following a workplace incident in Texas are critical for purposes of filing a claim for compensation. Follow the following steps to preserve your rights and learn how workers comp works.

Get Medical Attention

After you get injured or feel ill, the first step is to see a doctor. Don’t delay receiving help from a Texas healthcare professional. This could not only jeopardize your health, but you run the risk of missing time-sensitive deadlines in the workers’ compensation process.

Even if you believe that your injury is minor, get a proper medical report detailing the extent of the damage and how it occurred. This is the first step in the workers’ compensation claim process. Absent a medical report, your employer cannot file a claim with the insurance carrier.

When dealing with a job-related illness, the symptoms and diagnosis may not happen right away. You may find yourself attending regular checkups and testing for weeks or months before a doctor finally associates your illness with your job. All of your medical records will become the foundation from which the workers’ comp carrier will launch its investigation. Your doctor may make the determination that the illness is the result of your work conditions or aggravated by them. Once they do, see your human resources representative to file a workers’ compensation claim.

File a First Report of Injury

Once you have a medical diagnosis relating your illness or injury to your job, you must file a claim with your employer. This is the next important phase of how Texas workers comp works.

You must report the injury to your employer within 30 days of the date or discovery of the injury. You must also submit a claim to the Texas Department of Insurance, Division of Workers’ Compensation within one year of the date of injury or discovery.

The first report of an on the job injury or illness will provide the workers’ compensation insurance carrier with the details of the events leading up to the injury. In this report, you will provide your physical injuries, the medical treatment you received and the facilities that provided it. It’s always a good idea to submit a copy of the doctor’s report  with the report of injury.

Your employer should furnish you with information about the claims process. The adjuster or insurance carrier representative may want to speak to you at some point about the incident and any possible witnesses to the event. 

Texas law limits temporary disability benefits to 104 weeks. However, an exception is possible in cases involving spinal surgery. For permanent disability, once the maximum medical improvement has been reached, your doctor will assign a percentage value to your impairment. Benefits can be paid for a period of three weeks per percentage point. Supplemental or lifetime benefits can be available in certain cases involving severe or debilitating injuries.

Why You Should Hire a Workers’ Compensation Lawyer

In learning how Texas workers comp works, many people believe that the injury claims process is straightforward. While this may be the case in some instances, in others, it may be more of a hassle. For instance, your employer may question whether you were hurt on the clock or on your own time. The company may also start to question the extent of your injury. There may even arise pay disputes and long-term care dictated by the doctor. Don’t question how workers comp works and risk losing your claim. Hire a Texas workers’ comp lawyer and ensure you have an advocate to fight for your rights as a victim.

Work With an Experienced Local Lawyer in Texas

Your health and wellbeing need to come first. If you are hurt while working or find out an illness you are suffering is the result of your job, you will want to seek compensation. Since the workers’ compensation claims process may be tricky, you should consider getting a local attorney well versed in how to deal with it. We can even help you connect with an attorney across Texas state lines. They can guide you while you continue to learn how workers comp works.

Submit a request online or call us today at (866) 345-6784 to get in touch with an experienced lawyer in your area!

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