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Hurt On The Job? Learn Your Worker’s Comp Rights!

In the ever-accelerated world of the 21st century, jobs are demanding record levels of output and production. In almost every level of the economy, there’s a push for more results that often leads to injury. Laborers, truck drivers, and nursery assistants represent some of the most injuries and illnesses in the U.S, but there is a wide range of professions with a high risk. 

Claims and injuries continue to rise each year, and it’s important that you know your rights as well. Worker’s compensation in Texas is unique, so this article will discuss the basics of Texas worker’s compensation law. 

Texas Worker’s Compensation Insurance

When many people get injured in Texas, they expect to receive some form of compensation or support from their employer. However, Texas does not require companies to have a worker’s compensation system or program. Instead, worker’s compensation is an insurance program managed by the State. Only certain private, educational, or government employers are required to offer worker’s compensation. 

The system operates with an employer signing up for an insurance policy, and that insurance company actually paying for your benefits like income and medical care.  Benefits are not directly allocated by the employer or by the state of Texas.

Companies have to acquire worker’s compensation insurance for you to have access to it following an incident. If they don’t have it, you will not be covered for any worker’s compensation assistance. It is incredibly important that you check with your employer about their worker’s compensation coverage before you are injured or contract an illness on the job. Most employers do offer the program, though, so your company likely will offer the program.

Your Worker’s Compensation Rights 

If your company does have worker’s compensation, you have a number of rights backed by the state of Texas. You are entitled to income benefits, reasonable and necessary medical care, and you may keep your claim private and choose your own doctor to treat you. 

You also must be told if your claim is in a certain health care network, so you can choose the appropriate doctor. Medical care received by a doctor that is out-of-network may result in the bills being attributed to you, not the insurance company. 

Injured or ill employees may also hire an attorney or other legal assistance at any time during the process. Law firms like Quiñonez Law Firm help by ensuring the proper documentation is gathered, determining the amounts of benefits you require, and representing you in court if necessary. 

What You Need To Claim Worker’s Compensation 

Worker’s compensation is a wonderful program for those impaired on the job, but it is important that you follow the rules and protocol required to fully reap the benefits. 

First, your employer must be notified of your work-related injury/illness within 30 days of the incident. It would be best to notify your employer as soon as you are able to, to avoid missing the deadline. After 30 days have passed, your employer is no longer liable to offer compensation. 

You must also contact the Division of Worker’s Compensation (DWC) within a year of sustaining the injury or illness. The DWC represents the enforcement arm of the worker’s compensation system in Texas. The DWC ensures that all parties (employers, health care professionals, employees, insurance companies, etc.) are complying with Texas law. You will need to fill out a form detailing your injury and some personal information. 

Your Worker’s Compensation Benefits 

The benefits system is complex, given the many different circumstances in which worker’s compensation can be needed. The benefits system is categorized based on factors such as the severity of injury, length of injury, amount of payment received upon return, total income lost, etc. 

The types of benefits in Texas fall under the categories of Temporary Income Benefits, Impairment Income, Supplemental Income, and Lifetime Income. Below is a short description of each program:

Temporary Income Benefits 

Temporary Income Benefits are available when more than 7 days of work are missed due to a specific injury or illness. The days of missed work are not required to be consecutive. For example, missing 4 days one week and 4 days the next week would qualify for this program. 

This program entitles the injured worker to receive 70 to 75 percent of their normal income prior to being injured. This program ends once the injured worker is back working and earning their previous salary, are fully healthy, or have received care for 104 weeks. 

Impairment Income Benefits 

Impairment Income Benefits are awarded when the employee sustains some sort of permanent injury while on the job. The benefits received from this program are up to 70 percent of the income earned each week. Unlike the Temporary Income Benefits, this program is not dependent on whether you can go back to work or not. In fact, you may receive these benefits after you have returned to work. 

Eligibility for this program is determined by the amount of permanent damage that was caused, via an “Impairment Rating” determined by your doctor. The higher the rating, the more weeks of benefits supplied by the insurance company. 

Supplemental Income Benefits 

If a significant amount of permanent damage is suffered and the injured worker cannot return after the Impairment Income Benefits end, they may be eligible for Supplemental Income Benefits. While this is the most common reason to acquire these benefits, someone may also be eligible if they’ve returned to work and make less than 80 percent of their previous pay. 

You will need to be considerably impaired to qualify; an Impairment Rating of 15 percent or more is needed. 

You will also need to fulfill certain recurring requirements to maintain your benefits, like joining a vocational rehabilitative program and submitting job applications every 3 months. The benefits from this program equal 80 percent of the difference between 80 percent of the pre-injury pay and the current pay post-injury. 

For example, if John made $100 per week before the injury and makes $65 per week post-injury, the benefits would be calculated by subtracting $65 from $80 (80 percent of $100). This would equal a $15 per week difference in pay, where 80 percent would actually be provided by the program ($12). The benefits are provided monthly, so John could expect $48 a month from the program. 

This program can last up to roughly 8 years.

Lifetime Income Benefits 

The Lifetime Income Benefits program is typically reserved for the most serious injuries. Think loss of multiple limbs, serious brain damage, or blindness. 

These benefits equal 75 percent of the previous weekly income, with a 3 percent cost of living increase each year. These benefits can last a lifetime, hence the name of the program. 

Handling Disputes With Qualified Attorneys

If you are hurt on the job, it would be a great idea to hire legal counsel. In the event that there are discrepancies or disagreements between you and the employer, our team can support you through every step of the process. Call us today to schedule an appointment and fight for the worker’s compensation you deserve!

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