The Different Approach to Workplace Injuries in the Lone Star State
Texas handles workplace injuries differently than many other states. Employers in Texas are not generally required to carry workers’ compensation insurance, which means an injured worker’s options may depend on whether their employer participates in the system. When an employer subscribes to workers’ compensation coverage, a claim can provide quick access to certain medical and income benefits after a job-related injury.
When Can You File a Workers’ Compensation Claim in Texas?
In Texas, you can pursue a workers’ compensation claim only if your employer carries workers’ compensation insurance. If your employer does not carry that coverage, you will not have access to workers’ compensation benefits through that employer, but a personal injury claim may be one of the legal options available, depending on the facts.
What Should You Do After a Workplace Injury?
After a workplace injury, the steps you take can affect your health and your ability to pursue a claim for workers’ comp benefits or a legal claim for damages. Every situation is different, but injured workers should generally take the following steps as soon as they reasonably can.
1. Report the Injury to Your Employer
Tell your supervisor or employer about the injury as soon as possible. Even if the injury seems minor at first, reporting it creates a record of when and how the accident happened. Some injuries worsen over time, and waiting too long can make it harder to connect the injury to your job.
2. Seek Medical Care
If the injury is serious, emergency care should come first. For non-emergency injuries, follow the appropriate process for getting treatment, especially if your employer participates in the workers’ compensation system.
3. Document What Happened
Write down how the accident occurred while the details are still fresh. Include the date, time, location, what you were doing, who saw the accident, and whether any unsafe condition contributed to the injury. Photos, witness names, and copies of written reports may become important if the claim is disputed.
4. Follow Your Doctor’s Instructions
Attend follow-up appointments, follow work restrictions, and keep copies of medical records related to the injury. Missing appointments or returning to work too soon can create problems for your recovery and may also raise questions during the claims process.
5. Keep Track of Missed Work and Expenses
Save records showing missed work, reduced hours, medical bills, prescriptions, travel for treatment, and other injury-related costs. These records can help show how the injury affected your income, health, and daily life.
6. Get Legal Guidance If Questions or Problems Come Up
Workplace injury claims can become more complicated in certain situations—for example, if your employer does not carry workers’ compensation insurance, your claim is denied, your benefits are delayed, or you are pressured to return to work before you are ready. Speaking with an attorney can help you understand what options may be available under Texas law.
How Long Do You Have to Report a Workplace Injury?
One of the most common mistakes injured workers make is waiting too long to report an accident. Where an employer carries workers’ compensation insurance, Texas employees generally must notify the employer of a workplace injury within 30 days. Failing to provide timely notice can create complications and may affect eligibility for benefits.
Prompt reporting gives employers an opportunity to investigate the accident, document the circumstances, and begin the claims process. Delays can make it more difficult to establish what happened and may lead to disputes regarding the cause of an injury.
The reporting process is separate from filing a workers’ compensation claim. An injured worker may need to satisfy multiple deadlines depending on the circumstances of the case. Because missing a deadline can affect your rights, it is often beneficial to address workplace injuries early and keep copies of any reports or correspondence related to the accident.
What Can You Expect a Workers’ Compensation Claim to Cover in Texas?
Workers’ compensation benefits may help cover certain losses after a job-related injury. In many cases, that includes payment for approved medical care related to the injury as well as income benefits for qualifying lost wages.
The benefits available in a workers’ compensation claim can depend on several factors, including the nature of the injury, the medical treatment required, the amount of time missed from work, and the worker’s average weekly wage. Some injured employees need only short-term treatment and time away from work, while others may require ongoing care or face longer periods of recovery.
Workers’ compensation benefits may cover a wide range of injury-related medical needs, such as emergency care, doctor visits, diagnostic testing, physical therapy, medications, and other treatment connected to the workplace injury. Income benefits may also be available when an injury prevents an employee from working or limits their ability to return to the same job duties.
Because every claim is different, disputes sometimes arise over the treatment being provided, whether an injury has healed, or the amount of income benefits owed. Understanding what benefits may be available is often an important part of evaluating a workplace injury claim.
What Types of Injuries Are Covered by Workers’ Compensation in Texas?
Workers’ compensation may cover many different types of job-related injuries and occupational illnesses. In general, the injury or illness must arise out of and occur in the course of employment for benefits to apply.
Covered workplace injuries can range from relatively straightforward accidents to severe and life-changing harm. Depending on the circumstances, a claim might involve broken bones, back and neck injuries, burn injuries, repetitive stress injuries, traumatic brain injuries, spinal cord injuries, or other physical conditions connected to the job. Claims might also involve occupational illnesses caused by exposure to harmful chemicals or toxic substances or work-related conditions that develop over time, such as carpal tunnel syndrome.
The severity of a workplace injury can affect the medical care required, the time away from work, and the types of benefits available. In the most serious cases, a workplace accident may result in permanent impairment or death, which can raise additional issues involving long-term benefits or benefits for surviving family members.
Because every claim depends on its own facts, questions sometimes arise about whether an injury is work-related, how serious the condition is, or whether a worker’s job duties contributed to the harm. Those issues can affect both eligibility and the benefits available through the claim.
What Happens if Your Employer Does Not Carry Workers’ Compensation Insurance?
Texas is unusual because many employers choose not to participate in the workers’ compensation system. These employers are often referred to as nonsubscribers.
When a nonsubscriber employer does not carry workers’ compensation insurance, an injured worker cannot pursue traditional workers’ compensation benefits through that employer. Instead, the worker may have the option to pursue a personal injury claim if the injury resulted from negligence.
Unlike workers’ compensation claims, which generally provide limited benefits regardless of fault, a negligence claim may allow an injured worker to seek compensation for a broader range of losses. Depending on the circumstances, this can include medical expenses, lost income, pain and suffering, physical impairment, and other damages recognized under Texas law.
However, every workplace injury does not automatically result in a viable negligence claim. The specific facts surrounding the accident, including how the injury occurred and whether negligence played a role, can significantly affect the available legal options.
Does Filing a Work Comp Claim Prevent You from Filing a Lawsuit for Damages?
That depends. If all of your losses were caused by your employer or a co-worker, workers’ compensation will be your exclusive remedy for any injury or loss. If, however, your injuries were caused, in whole or in part, by an unrelated third party, you may bring a civil lawsuit to recover damages from that third party.
Can You Be Fired for Filing a Workers’ Compensation Claim?
Many injured workers worry that reporting an injury or pursuing benefits could jeopardize their employment. Concerns about retaliation sometimes cause employees to delay reporting injuries or avoid filing claims altogether.
Texas law provides certain protections for employees who exercise their rights under the workers’ compensation system. However, workplace disputes involving discipline, termination, or allegations of retaliation can be complicated and often depend on the specific facts involved.
If an employee believes adverse action was taken because of a workplace injury report or workers’ compensation claim, it is important to preserve relevant records, including emails, written warnings, performance reviews, and other documentation related to the situation. Because retaliation claims often depend on documentation and timing, addressing concerns promptly can help protect an employee’s ability to evaluate potential legal options.
Why Workers’ Compensation Claims Are Sometimes Disputed
Although workers’ compensation is designed to provide benefits to injured employees, disagreements sometimes arise during the claims process. Disputes can involve the cause of an injury, the medical treatment being provided, or the benefits an injured worker is receiving. Understanding some of the most common areas of disagreement can help workers recognize potential issues and respond appropriately.
Disputes About Whether an Injury Is Work-Related
One common issue involves questions about whether an injury actually occurred in the course and scope of employment. For example, disputes may arise when an employer or insurance carrier believes an injury happened outside of work or resulted from a pre-existing condition rather than a workplace accident. These issues can be especially common when symptoms do not appear immediately after an accident or when a worker has a history of similar medical problems. Establishing when and how an injury occurred is often an important part of the claims process.
Disputes About Medical Treatment
Disagreements may also develop regarding medical care. Questions can arise about whether a particular treatment is necessary, whether an injury has fully healed, or whether additional care should be approved. In some cases, healthcare providers and insurance representatives may have differing opinions about the extent of an injury or the need for ongoing treatment. These disagreements can affect both the medical care a worker receives and the benefits available through the claim.
Disputes About Disability Benefits
Workers and insurance carriers may also disagree about disability benefits and lost wage payments. These disputes can involve issues such as an employee’s ability to return to work, the extent of work restrictions, or the calculation of wage-related benefits.
When disputes arise, obtaining accurate information about the claims process can help injured workers make informed decisions about how to proceed.
Contact Bailey & Galyen About a Texas Workplace Injury Claim
A workplace injury can leave you dealing with medical treatment, missed time from work, and questions about what benefits or legal options may be available. Whether your employer carries workers’ compensation insurance or not, it is important to understand how Texas law may apply to your situation. Bailey & Galyen helps injured workers and their families evaluate workplace injury claims, address disputes, and better understand the next steps. Contact us by email or call our offices at 844-402-2992. Our phones are answered 24 hours a day, seven days a week.
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