When you are injured on the job and need to take time off to get better, your world may be turned upside down. The fear of missing work and, therefore, losing out on wages adds to the stress you are already experiencing. Fortunately, that's why workers' compensation is required in Texas. It's a way to protect employees when they are injured while working. But workers' compensation is not always straightforward, and employers will sometimes challenge your claim, adding insult to injury.
At The Law Office of Orlando Zambrano, our workers' compensation attorney in Texas handles all types of workers' comp cases. We help both employees and employers comply with the law. We also ensure their rights are upheld and provide guidance so that they meet their respective responsibilities. One thing we know is this: informed clients make better decisions. Here, we answer many of the most commonly asked questions we get about workers' compensation. To get more specific answers, however, it is best to contact our workers' comp lawyer at 832-422-9399 to schedule a FREE CONSULTATION.
What Constitutes Workers' Compensation in Texas?
Workers' compensation is a type of insurance that allows injured employees to obtain needed medical care and compensation when they have been injured on the job. Specific rules and the way workers' compensation is administered vary from state to state.
Workers' compensation benefits employees in several ways. Namely, it provides monetary compensation to cover lost wages while the employee gets the medical care they need. But also, getting a check via workers compensation is easier, more reliable, and quicker than filing a lawsuit for a personal injury or wrongful death.
As for employers, workers compensation insurance prevents workers from suing an employer for an injury suffered on the job. Avoiding lawsuits benefits the employer because workers' compensation does not compensate for pain and suffering, but a lawsuit would allow those types of damages. Workers' comp insurance saves the employer from extra legal and financial woes.
What Does Workers' Compensation Cover?
Each state provides their own specific laws and rules on workers' compensation. That said, in most states, workers' compensation compensates employees for the following costs that an injured employee may collect due to the injury and inability to work:
- Wages Lost. On the job injuries can cause employees to miss work. Workers' compensation provides monetary compensation when this happens, although it may not reflect an amount equal to what the employee would have earned had they been able to work. Typically, it is a percentage, like 80 percent or less, depending on state law and the facts and circumstances.
- Medical Care. Medical care received by an injured employee is covered by workers' compensation. This includes doctor visits, emergency room visits, and any needed surgeries.
- Medications. Necessary medications are also covered by workers' compensation.
- Vocational Rehabilitation. Vocational rehabilitation is a type of therapy created to help a person gain the skills necessary to return to work. Sometimes, when an injured employee is unable to return to the same job because of their injury, workers' compensation will pay for them to attend vocational rehabilitation so they can learn the skills needed for a new type of work.
- Physical Therapy. Physical therapy is designed to help an injured person restore movement, such as standing and walking. When needed after an injury, workers' compensation will generally pay for physical therapy.
When an employee is killed while working, workers' compensation typically provides death benefits. This can include payment for the funeral of the deceased as well as provide additional financial compensation to the family members of the deceased. States differ on whether these benefits are provided and, if they are, what the amount will be.
What Does Workers' Compensation Not Cover in Texas?
While workers' compensation provides compensation for many different job injuries, there are limits to what it will cover. The following are some examples of situations where workers' compensation may not be available.
- Injuries an employee sustains while under the influence of drugs and alcohol
- Injuries purposefully sustained by an employee
- Injuries sustained by an employee while engaged in a practical joke
Each state may have other situations where workers' compensation will not provide compensation for injuries.
Who Pays for Workers' Compensation in Texas?
Employees do not pay for workers' compensation insurance. Instead, employers must purchase it. Most employers purchase coverage from an insurance company or through a program administered by the state. In some cases, large employers fund their worker's compensation program through self-insurance.
Must Employers Carry Workers' Compensation Insurance?
While the particulars of how a workers' compensation program is administered vary from state to state, most states require some type of coverage for employers who employ only a small number of employees. Some states require coverage even if an employer only has one employee.
In reality, workers' compensation is something employers should want because of the protections it offers.
What Happens if an Employer Refuses to File a Workers' Comp Claim in Texas?
It is possible that an employer will refuse to file a claim on behalf of an injured employee. There could be a number of founded and unfounded reasons for this refusal, from suspicions that the injury did not happen while at work to worries that insurance premiums will increase. Whatever the reason, when an employer refuses to file the claim, the employee is left in a precarious position.
If you are an employee injured on the job, you must put your employer on notice in writing immediately after the injury occurs. You should also seek medical assistance. Then, if the employer challenges your claim, it is in your best interest to retain a competent workers' compensation attorney in Texas.
Can an Employee Still Get Compensation if the Injury Is Reported Late?
The answer to this question honestly depends on the state and the type of injury. Some injuries are accompanied by delayed symptoms, like whiplash, so you may not know you are injured until after the injury is sustained. Likewise, other injuries may be known, but their connection to the job may not be obvious until later down the road.
For these reasons and more, it may be possible for an injured employee to obtain compensation even when they do not report their injury within the time allotted by state law.
Are Diseases Covered by Workers' Compensation?
Yes, a disease can be considered an "injury" for the purpose of workers' compensation. If a person must work in and around toxic chemicals, for example, and they later develop a respiratory disease or another disease, like cancer, as a result of the exposure, then it is compensable if you cannot work while you recover.
Are Mental Health Issues Covered by Workers' Compensation?
Yes, mental health issues are covered by most workers' comp programs when the mental health injury is caused by the employee's job. Common mental health injuries include:
- Post-Traumatic Stress Disorder (PTSD)
- Anxiety disorders
Keep in mind, however, these types of injuries are harder to prove than physical injuries. The mental health injury must be severe enough that you cannot perform your job duties.
Can an Employee Select Their Own Doctor for a Workers' Comp Claim?
In most cases, an employee cannot choose which doctor to see for purposes of workers' compensation, but instead they must see the doctor ordered by the employer and/or workers' comp insurance carrier. This requirement is only if the employee wants workers' comp, but employees are always welcome to visit their own doctors as well.
If an employee does not agree with the assessment made by the employer's doctor, they can seek the guidance of a workers' comp attorney in Texas to discover what other options may be available.
How Long Does Workers' Comp Last in Texas?
The duration of workers' compensation depends specifically on state law and the severity of the injury. Benefits can be temporary or permanent and include full or partial disability.
Do I Need a Workers' Compensation Lawyer in Texas?
As with most things, whether you need a workers' comp lawyer depends on the facts and circumstances of each case. Both employers and employees may need a workers' comp attorney to assist with any given issue. The more challenging the case, the more likely a workers' comp attorney is needed.
Employees may specifically want to hire a workers' compensation lawyer when:
- They have a pre-existing condition
- Symptoms were delayed or developed over time
- Benefits are denied or delayed
- They are prematurely cleared to work
- Reasons exist not to trust the company doctor
- An employer wants them to take an independent medical exam
- An employer claims they are not covered by workers' comp
- An employer accuses them of fraud
- They are or will soon be eligible for Medicare
Keep in mind, the above are not the only reasons to retain a workers' comp lawyer. Do you and/or your workers' comp claim face any specific or unique challenges? It never hurts to get a qualified opinion, especially when your future financial and medical situation may depend on it.
Contact a Workers' Comp Attorney in Texas Today
Workers' compensation in Texas is there to protect both the employer and employees. Generally, the process goes smoothly, but when it does not, a workers' compensation attorney should be consulted. At The Law Office of Orlando Zambrano, our workers' comp lawyer in Texas handles these types of cases and will handle yours with integrity and due diligence. Contact us by filling out the online form or calling us at 832-422-9399 to schedule a FREE CONSULTATION.