Are You Covered by Workers’ Compensation in Texas?

Texas is unique in that it’s one of the only states where an employer has the option of whether or not to provide workers’ compensation coverage to their employees. Workers without true WC coverage will likely need to pursue a personal injury claim in order to recover compensation.

Workers’ compensation is a state-regulated insurance program for employees who become injured or fall ill during the course and scope of their employment. It allows a person who is injured on the job to recover a portion of their lost wages and receive medical treatment, without having to prove that the employer was negligent in causing the injury.

While workers’ compensation may seem like a benefit to employees, it’s important to note that it also protects employers. Businesses who subscribe to workers’ comp coverage are essentially shielded from lawsuits brought by injured workers, meaning a victim’s only option to recover compensation is often through the administrative workers’ comp claims process.

Because this type of coverage can be expensive within certain industries, many employers in our state choose to opt out of the program. Some employers may choose to provide a non-state-approved insurance program to their employees, but they would still be considered “nonsubscribers” under the law and would not be protected from lawsuits brought by injured workers.

If you’re injured on the job in Texas, do not take your employers word with regard to your legal options. Call 214-720-6090 (local) or 1-833-720-6090 (toll-free) and discuss the facts of your case with us for no cost. We can verify whether or not your employer actually has workers’ compensation, and are happy to answer your questions 24 hours a day.

If you were injured due to a work-related incident and are certain that your employer subscribes to workers’ compensation insurance, in order to qualify for WC benefits, you must promptly notify your supervisor and file an accident report with your employer. Further, you must be examined by an approved physician before you can receive benefits, and must follow all treatment and care recommendations.

Unlike a regular injury claim or lawsuit, the benefits you can seek through a workers’ compensation claim are quite limited. Under a workers’ compensation claim, you cannot seek anything other than income benefits and medical benefits. If the claim involved a worker’s wrongful death, the victim’s family can receive burial expenses (up to a certain limit) and certain death benefits (75 percent of the deceased employee’s average weekly wage, subject to restrictions).

Income benefits typically include:

1. Temporary income benefits. Compensation for lost wages only kicks in if the victim misses a minimum of seven days due to injury or illness. After seven days, you can receive 70% of your average weekly wages. These benefits end when you reach maximum medical improvement (MMI), or when you can return to work, or at the end of 104 weeks following your 8^th day of eligibility.
2. Impairment income benefits. Those who have sustained a permanent disability as a result of the injury may seek impairment income benefits after reaching MMI. Victims are eligible to receive three weeks of benefits for each degree of impairment. Impairment income benefits are based on 70% of the average weekly wage (to a maximum amount).
3. Supplemental income benefits. These benefits may be available to those who’ve already reached MMI and have obtained an impairment rating, so long as you meet the following conditions:
   1. Your impairment rating is at least 15%
   2. You have not returned to work or are earning less than 80% of your average weekly wages after returning to work.
4. Lifetime income benefits. You may be eligible for lifetime benefits if the injury was especially catastrophic (e.g., blindness, paralysis, amputation of multiple limbs, traumatic brain injury). Lifetime benefits are calculated as 75% of your average weekly wage, and terminate upon death.

Even though workers’ comp claims do not require the victim to show proof of employer negligence, many workers’ compensation insurers will deny your claim for benefits due to a variety of reasons. They may allege that you were not injured on the job, that the injury was preexisting, that you were impaired at the time, or that the event was an “act of god.”

The “approved physician” you see may also assert that you should return to work despite your continuing disability or inability to substantially perform your work duties. If you are having any issues regarding your workers’ compensation claim, it’s important to speak to an attorney about your rights.

If you discover that your employer is a non-subscriber, then you need to contact a personal injury lawyer as soon as possible. Bringing a negligence-based work injury claim will require quite a bit more effort than a workers’ comp claim, but the upside is that it allows you to seek far more in monetary damages—and our law firm can handle your entire claim on a no-win no-fee basis.

With these type of claims, your attorney must be able to prove that not only was your employer negligent (e.g., failing to warn you of a hazard, providing poor training, failing to provide a safe working environment, etc.), but also that they are liable for your resulting damages.

Damages sought in personal injury claims differ somewhat from workers’ compensation benefits. In a personal injury claim, you can seek to be reimbursed for 100 percent of your related losses, including:

• Past and future loss of income
• Lost earning capacity
• Past and future medical expenses
• Compensation for pain and suffering
• Compensation for disfigurement or impairment
• Compensation for emotional trauma, loss of consortium, etc.

Regardless of whether or not your employer subscribes to worker’s comp, if your injuries were caused by a defective product (e.g., malfunctioning machinery, faulty power tools, etc.), then you may actually have a product liability injury claim against a third party; not your employer. Likewise, if you were injured in a car accident while in the course and scope of your employment, you can still bring a negligence claim against the at-fault motorist.

The bottom line is that if you were injured on the job in Texas, your options for recovering compensation depend heavily on a variety of factors. You need someone on your side looking out for your best interests, and we’re happy to help with your claim on a no-win no-fee basis. For a free consultation, call Montgomery Law at 214-720-6090 (local) or 1-833-720-6090 (toll-free) and let us explain how our law firm can help.