Worker’s compensation insurance (workers’ comp) provides income and medical benefits to individuals who suffer a work-related injury.
The workers’ comp system dispenses with long lawsuits and disputes over fault to deliver benefits swiftly to the injured worker to protect them from financial hardship and uncertainty.
What Is Workers’ Compensation?
Workers’ compensation is an insurance policy held by your employer which pays benefits to cover the costs of your work-related injury.
Most Texas employers elect to have workers’ compensation for several reasons, the most common being that it prevents employees from suing the employer for work-related injuries.
If your employer doesn’t have workers’ compensation insurance, they could find themselves paying a potentially large workers’ comp lawsuit settlement in TX.
The upside for the employee is that they don’t have to prove their employer was negligent to receive benefits.
However, workers’ compensation benefits are typically much more modest than the damages recoverable in a personal injury suit because they do not include noneconomic damages such as pain and suffering.
What Do I Do When I Am Injured?
When you suffer injury on the job, you must report your injury to your employer within 30 days of when it occurred. You also need to report the injury to your doctor and tell them how it happened.
Make sure they know that it was work-related. Finally, within one year of your work-related injury you must inform the Texas Department of Insurance.
Failure to do any of these things on time may disqualify you from workers’ compensation benefits.
How Do I Receive Workers’ Compensation Benefits?
Depending on the type of benefit and how your injury is classified, workers’ comp benefits are paid a few different ways in Texas.
Most workers’ comp benefits are paid in weekly installments or as costs are incurred. For instance, temporary income benefits are paid on a weekly basis, and medical benefits are paid when you get a doctor’s bill. There is no option in Texas to receive these benefits as a lump sum or settlement.
However, impairment income benefits (not to be confused with temporary or supplemental income benefits) can be paid as a lump sum.
To qualify for an impairment income lump sum payment, you have to meet specific standards with regard to disability rating, minimum work periods, and wages earned.
In addition, receipt of the lump sum payment may disqualify you from receiving other benefits. Often an impairment income lump sum payment is referred to as a settlement.
While that characterization is not entirely correct, in effect the lump sum does end up “settling” a portion of the workers’ comp benefits claim in a single payment.
What Do Workers’ Compensation Benefits Pay For?
Workers’ compensation benefits are not always paid directly to you. The nature of the expenses will determine how the benefits are paid.
Generally, benefits are paid as follows:
- Medical and rehabilitation expenses—paid to the provider,
- Temporary income—paid to you,
- Impairment income—paid to you,
- Supplemental income—paid to you,
- Lifetime income—paid to you, and
- Death and burial expenses—paid to your estate.
Bear in mind, the above list has several specific triggering events (e.g., temporary income triggers after missing seven days of work), and you may not qualify for every benefit (e.g., impairment income or lifetime income etc.).
Further, the amounts paid as temporary or supplemental income are calculated as a portion of your wages (e.g., approximately 70% of your wages).
Can I Be Disqualified from Workers’ Compensation?
While you don’t have to prove fault to receive workers’ compensation benefits, you can still be disqualified under the following circumstances:
- You were intoxicated when the work-related injury occurred,
- It was the result of “horseplay” at the work site, or
- The injury was self-inflicted.
Absent the occurrence of any of the above, you should qualify for workers’ compensation benefits as long as you can show your injury was work-related
Do I Give Anything up When I Receive Workers’ Compensation?
When you receive workers’ compensation benefits you give up the right to sue your employer, co-workers, and some third parties.
Also, there is no avenue to receive non-economic damages like pain and suffering in a workers’ comp lawsuit settlement.
In addition, you will only receive a portion of your wages as temporary or supplement income benefits. Finally, you may face restrictions on which doctors you can see for treatment.
The Zimmerman Law Firm Can Help Maximize Your Benefits
At The Zimmerman Law Firm, we have over 85 years of combined experience representing injured individuals just like you.
Our attorneys are highly experienced in the details of workers’ compensation claims and have recovered millions of dollars on behalf of our clients.
Contact us today so we can help you understand your benefits and make sure you get the most out of your workers’ compensation claim.