Being injured while on the job can be devastating.
Physical injuries, medical bills, and time away from work while in recovery—it can all feel overwhelming and complicated to navigate.
Unfortunately, dealing with the aftermath of your Texas workplace injury can be even more complex.
If you sustained a workplace injury, you may be entitled to relief through a Texas workers’ compensation claim.
But where do you begin?
The first step to getting the recovery you deserve is to contact a Texas workers’ compensation attorney to discuss your claims.
With over 85 years of combined legal experience, the workplace injury lawyers at The Zimmerman Law Firm, P.C., are well-prepared to handle your case.
Give our team a call today at (254) 752-9688 or submit the short form below to speak with a Texas workers’ comp lawyer, and get started on fighting for your rights and pursuing your work injury claim.
“They said my employer has Texas Workers’ Compensation, but I didn’t really know …”
Filing for Texas Workers’ Compensation Benefits
If my employer does not have Texas Workers’ Comp insurance, what can I do to get help with my bills, lost wages, and medical needs?
I know my employer has Texas Workers’ Comp insurance, but how do I know that I am getting paid weekly and fairly? What are my rights in Texas?
If my injury involved someone other than my employer (third party), which is not covered by Texas Workers’ Comp, can I still get medical and financial help?
These are questions that many workplace injury and oilfield accident victims have. And while they may be complicated, the good news is that you don’t have to answer them alone.
How Does Workers’ Comp Work in Texas? An Overview of Texas Workman’s’ Comp Laws
Workers’ compensation is a state-regulated insurance program that provides workers who sustain work-related injuries or illnesses with medical and income benefits if their employer subscribes to workers’ comp.
Importantly, the injury or illness must be work-related. Thus, you must have sustained the injury or illness while working and/or in connection with your job-related duties.
But after sustaining your workplace injury, where do you go to proceed with your workers’ compensation case? There are a few key steps that you should follow to get the benefits you need to recover.
Step 1: Report Your Workplace Injury or Illness
The first step is to report your injury or illness to your employer.
This starts the timeline for the entire workman’s comp claims process. Thus, it is imperative that you report as soon as possible after your injury occurs or after you become aware of your work-related illness. In fact, failure to do so promptly could jeopardize your entire claim.
Step 2: Seek Medical Attention
After you report your injury, your employer should provide you with details on how you can seek medical attention.
Some employers may require that you seek your medical care from a specific provider or workers’ comp health care network. If this is the case, make sure to comply with these requirements. Otherwise, you may seek out the care of any physician approved by the Texas Division of Workers’ Compensation (DWC).
Regardless of what physician you select, don’t forget to tell them at the outset that your injury or illness occurred while at work. You should also be sure to tell your doctor all other relevant facts related to your injury. This will ensure that you receive appropriate diagnosis and treatment moving forward.
Step 3: File Your Workers’ Compensation Claim
Now you are ready to file your claim. You must complete and file an Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease with the DWC.
The claim form will ask for information related to your:
- Injury or occupational illness,
- Work status, and
- Selected physician.
However, don’t wait too long to file your claim form. You must file your claim for Texas workers’ compensation benefits within one year of the date of your injury or from the date you knew or should have known the injury or disease may be work-related. Except in rare circumstances, failure to do so can result in a loss of your benefits.
If you have questions about how to complete and file your claim, do not hesitate to contact a Texas workers’ comp lawyer. In fact, the claim form includes a space to designate whether you have the assistance of an attorney.
Filing the initial claim form is a crucial step in the process. Thus, it can’t hurt to have one or more experienced workplace accident lawyers in your corner to help you along the way.
Types of Texas Workers’ Compensation Benefits
Sustaining injuries or becoming ill in the course of your work-related duties can lead to financial losses.
Expenses for medical care and treatment can rack up quickly. Further, you might lose out on valuable wages because you have to miss work while you recover. And sometimes, your injuries are so severe that you can never return to your job in the same capacity that you once could.
While this can be devastating to come to terms with, Texas workers’ compensation benefits fortunately provide an avenue for recovery.
Income benefits can replace a portion of wages that you may lose because of a work-related injury or illness.
There are four types of Texas workers’ compensation benefits that we’ll explain below:
- Supplemental, and
These benefits can sustain you during different stages of your claim, making it easier to cope with injury-related setbacks.
Temporary Income Benefits (TIBs)
You may be able to receive temporary income benefits (TIBs) if your work-related injury or illness causes you to lose all or some of your wages for more than seven (7) days. Workers’ compensation pays temporary income benefits (TIBs) on a weekly basis.
TIBs Minimum Rate (Oct. 2020-Sept. 2021) = $151
TIBs Maximum Rate (Oct. 2020-Sept. 2021) = $1,007
You become eligible for TIBs after you miss eight (8) days from work.
Your TIBs will end when one of the following occurs:
- A healthcare provider determines that you have reached maximum medical improvement (MMI), the point at which no further recovery from your injury is expected;
- You earn the average weekly wage you received from your employer before your injury; or
- You reach the end of your maximum TIBs benefits period, 104 weeks after the eighth day of your disability.
It is also important to note that in the context of a workers’ compensation claim, disability refers to your inability to earn an income. It does not necessarily mean a physical handicap.
Impairment Income Benefits (IIBs)
Impairment income benefits (IIBs) are paid to Texas workers whose work-related injuries or illnesses affect their bodies as a whole. IIBs are also paid out weekly and are typically paid to an injured worker who has reached MMI and received an impairment rating (IR) higher than 0%.
A healthcare provider will determine your IR by assessing your injuries and calculating a percentage of permanent damage to your body. Injured workers are eligible to receive three weeks of IIBs for each percentage of impairment.
IIBs Minimum Rate (Oct. 2020-Sept. 2021) = $151
IIBs Maximum Rate (Oct. 2020-Sept. 2021) = $705
You become eligible for IIBs the day after you reach MMI. These benefits will end after you have received three weeks of IIB payments for each percentage point of your IR.
Supplemental Income Benefits (SIBs)
Supplemental income benefits (SIBs) are income benefits that you apply for quarterly (four times per year, or every three months). However, they are paid monthly to injured employees who meet specific eligibility requirements.
To qualify for SIBs, you must:
- Have an IR of 15% or more;
- Not have returned to work, or if you have, have earned less than 80% of the average weekly wage for your position due to your injury;
- Prove that you are currently looking for work; and
- Not accept any lump sum payment for your injury.
If you have questions about whether you qualify for SIBs, contact a Texas workers comp lawyer today.
SIBs Minimum Rate = N/A
SIBs Maximum Rate (Oct. 2020-Sept. 2021) = $705
If you are eligible, SIBs will begin the day after your IIBs end.
Your entitlement to receive SIBs ends at 401 weeks (approximately seven and one-half years) from the date of your injury.
Lifetime Income Benefits (LIBs)
In some scenarios, you can receive lifetime income benefits (LIBs). As the name suggests, certain work-related injuries may result in a condition for which you are entitled to income benefits for your lifetime. Workers’ compensation pays these benefits weekly.
LIBs Minimum Rate (Oct. 2020-Sept. 2021) = $151
LIBs Maximum Rate (Oct. 2020-Sept. 2021) = $1,007
Examples of situations in which you may be entitled to LIBs include:
- Total and permanent loss of sight in both eyes;
- Loss of both feet;
- Loss of both hands;
- Third-degree burns that require grafting and cover at least 40% of the body; and
- Permanent paralysis of limbs.
While this is not an exhaustive list, a workers’ comp lawyer in Texas can help you determine whether you may qualify for LIBs for other reasons.
What Are Common Types of Work Injuries?
It does not take much to suffer a significant work injury, and injury is often the result of your attempts to work hard.
According to the National Safety Council, the top three causes of work injury are:
- Slip and falls, and
- Contact with equipment.
The common results of these accidents are back injuries, sprains, strains, tears, cuts, and punctures. The typical amount of days lost from work for these injuries is approximately one to two weeks. Many people cannot afford to lose two weeks’ worth of wages, and the added stress of managing a work injury can be overwhelming. If you are hurt at work, a lawyer can reduce your stress by recouping a part of your wage losses and helping you receive proper medical care.
What Industry Has the Highest Amount of Work Injuries?
While work-related injuries can occur in any profession, there are some professions that prove more frequently hazardous than others.
Nationwide, overexertion, slip and fall, and equipment contact injuries frequently occur in transportation, warehousing, construction, and agriculture jobs. In 2019, privately employed Texans working in transportation, utilities, and trade suffered the highest amount of injuries requiring time off. Texas employment in transportation, utilities, and trade grew 1.5% from 2015 to 2020, increasing the likelihood of Texas workers needing more than a month off from work due to injury.
If your work injury is severe enough that you require more than a month off, you likely don’t have the time or resources to manage the intricacies of your workers’ compensation claim alone. Texas Workers’ Compensation lawyers can address your work injury losses while you do the hard work of rehabilitation.
Texas Workplace Accident Injury Statistics
In 2019, almost 50,000 Texans working in private industry suffered a work injury requiring time away from work. Almost 16,000 of those injuries were strains, sprains, and tears, and approximately 16,000 injuries were upper extremity injuries.
Almost 30% of injured workers had to take a month or more away from work. Texans working in natural resources and mining and those working in information had the highest incidence of injury-related absences of a month or more—at approximately 40% and 58%, respectively. These statistics are scary, but workers’ comp lawyers in Texas understand industry risks and can help you manage your claim.
Losing more than a month of work can have disastrous effects on your life, and a work injury carries a substantial chance of this kind of loss. A workplace injury attorney can help you recover maximum wage loss benefits quickly while you rest and heal.
Workers’ Comp Claims vs. Personal Injury Lawsuits
Workers’ compensation benefits are your exclusive remedy against an insured employer, but not all Texas employers have workers’ compensation insurance. If your employer is uninsured or if a third party injures you during work, you can file a personal injury lawsuit.
Compared to workers’ compensation claims, personal injury lawsuits have advantages and disadvantages a work injury lawyer can help you evaluate.
You Do Not Have to Prove Fault in a Workers’ Compensation Claim
In a workers’ compensation claim, you do not have to prove that your employer negligently or intentionally caused your injury. To receive workers’ compensation benefits, you just have to prove that you were an employee (not an independent contractor) at the time of injury and your injury is compensable. A compensable injury is an injury that occurs while you are working and is the result of your work duties. You can recover workers’ compensation benefits even if you negligently caused your own injury, as long as you were not intoxicated, you didn’t intentionally cause your injury, you didn’t injure yourself while attempting to unlawfully injure someone else, and you weren’t engaging in horseplay.
To recover in a personal injury case, you have to prove that your employer or a third party negligently or intentionally caused your injury. A personal injury case can yield a higher award, but it is a riskier option.
Personal Injury Damages Can Be Higher but Can Take Longer
In a workers’ compensation claim, you can recover only wage loss benefits, impairment benefits, and benefits for medical care. If you file a claim on behalf of a worker who died from a work injury, you can also receive death and burial benefits. Generally, you cannot recover punitive damages unless your claim involves a worker who died due to an employer’s intentional act, omission, or gross negligence.
In a personal injury lawsuit you have access to a larger variety of remedies, including:
- Wage loss,
- Medical costs,
- Property damage,
- Pain and suffering, and
- Punitive damages.
As mentioned previously, workers’ compensation income benefits also have legally mandated maximums that are not applicable to personal injury awards. Not only are there statutory caps to your wage loss benefits, the rate of income benefits is only up to 75% of your average weekly wage. Conversely, personal injury lawsuits allow you to recover 100% of your lost wages.
Although a personal injury claim can yield a higher recovery, you do not recover anything unless you win at trial or settle, and it may take up to a year to win at trial. In a workers’ compensation claim, you can receive medical benefits immediately, and you can receive weekly income benefits after the seventh day of wage loss.
Workers’ Compensation Limits Your Choice of Doctors
While any doctor can treat you in a personal injury claim, your workers’ compensation doctor must come from a list the Workers’ Compensation Commissioner approves. The same workers’ compensation doctor manages your treatment from start to finish and makes crucial decisions that determine your care, your impairment rating, and your benefit amount. You cannot change your workers’ compensation doctor without making a special request.
You have more freedom to change doctors in a personal injury claim. Unlike workers’ compensation, you might not receive reimbursement for personal injury medical care until you win at trial or settle with the defendant.
Depending on the circumstances, you could have access to multiple kinds of remedies after a workplace injury. A work-related injuries lawyer can analyze and determine your best options for maximum recovery.
Third Party Workers’ Comp Claims
If your employer has workers’ compensation insurance but someone not associated with your employer caused your injury, you have multiple recovery options. You can file a workers’ compensation claim against your employer and a personal injury lawsuit against the third party. However, if you win against a third party, your employer can request reimbursement from your trial award for future and present workers’ compensation benefits paid. You have one year to file a workers’ compensation claim and two years to file a personal injury lawsuit. A work injury lawyer can meet all applicable deadlines and organize your multiple cases.
Questions? Contact a Texas Workers’ Compensation Attorney Today
Dealing with the aftermath of a work-related injury or illness can be scary. But a Texas workers’ comp lawyer can help.
If you are looking for an attorney to help you with your claims, the job injury lawyers at The Zimmerman Law Firm are here to help.
We have a team of qualified workers’ comp lawyers in Texas who have dedicated their practice to helping injury victims in need. With more than eight decades of combined legal experience, we are confident that our workplace injury lawyers have the knowledge and experience necessary to help you pursue your claims.
Workers’ Compensation FAQs
No. As long as your injury is job-related, it’s covered. For example, you will be covered if you are injured while traveling on business, doing a work-related errand, or even attending a required business-related social function.
Businesses and contractors that have workers’ comp insurance policies also have Employer Liability and Business Auto Liability insurance policies. These policies will compensate employees and independent contractors for injuries.
Workers’ compensation, or workman’s comp, is a state-regulated insurance program that provides compensation to employees who suffer job-related injuries and illnesses.
No. First of all, not all employers have to have workers’ compensation coverage. State laws vary, but an employer’s responsibility to provide coverage usually depends on how many employees it has, what type of business it is, and what type of work the employees are doing. In Texas, workers’ compensation insurance is optional for all employers, but if your employer does not carry it, you can sue them under personal injury law.
Your injury need not be caused by an accident—such as a fall from a ladder—to be covered by workers’ compensation. Many workers receive compensation for injuries that are caused by overuse or misuse over a long period of time.
Workers’ compensation covers most, but not all, on-the-job injuries. The workers’ compensation system is designed to provide benefits to injured workers, even if an injury is caused by the employer’s or employee’s carelessness. But there are some limits.
An injured employee who believes he or she is eligible for lifetime income benefits (LIBs) may submit a written request to the insurance carrier. The insurance carrier must respond within 60 days of receiving the request. Lifetime income benefits (LIBs) payments must begin on or before the 15th day after the insurance carrier decides.