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10/21/2021

Many categories of employees in Texas suffer workplace injuries and illnesses. These issues can adversely affect their employment prospects and financial status. It gets worse if it results in a disability. Furthermore, if the injury or illness results in death, the burial expenses and funeral costs will significantly burden the deceased worker's family. Am I eligible for worker's compensation?

That's why workers' compensation insurance is a great source of hope and joy for all categories of workers in Texas. You can file a claim for workers' compensation and access temporary income benefits and death benefits, depending on the extent of the injuries. However, it'll be best to have the comp attorneys at Calhoun, Meredith & Sims represent you through the process.

What Is Workers' Compensation?

Am I Eligible for Workers’ Comp in Texas?

Even if an employer removes all unsafe work conditions, workers may well suffer a work-related injury. It could also be a job-related illness. Injuries, illnesses, and disabilities could be from a work-related accident. When these happen, workers often face loss of wages and other significant financial dangers. That's the essence of workers' compensation insurance.

Workers' compensation is one of the common types of insurance available. It provides medical benefits and wage replacement for injured Texas workers. One of the purposes of workers' compensation is to protect the employee from the effects of their inability to work. Under the compensation law of most American states, injured workers who can't work can still receive their weekly wage.

Usually, employers are mandated by law to take out this compensation insurance policy for their workers. The Texas Workers' Compensation Act regulates workers' comp issues in Texas. It dictates which categories of employers, workers, and illnesses fall under comp insurance. Under the Act, an employer is anyone who makes a contract for hire, employs one or more employees, and has workers' insurance coverage.

It isn't only a private-sector employer that may take out work comp insurance. Public employers are also part of the definition of employers under the Act. They include a government entity that self-insures, individually or collectively.

Am I Eligible for Worker's Compensation? Who Is Eligible for Workers' Comp in Texas?

Compensation eligibility is an important topic for the insurance carrier, employer, and employee. Workers' compensation isn't compulsory in Texas, so workers may choose not to subscribe to it. Therefore, the first step to determining eligibility is to find out whether your employer has any insurance. Then you must also establish that you're an employee. So, if your employer bought workers' comp insurance and you, as an employee, suffered a work-related injury or disease, you may be eligible for compensation.

Notice of Injury

Texas law requires injured or sick employees to report their damage to their employer. This is if the wound was caused by a work accident. Sec. 409.001 of the Texas Workers' Labour Code provides that an employee or their representative must notify the employer of the work injury within 30 days.

The time starts to count from the date of the injury. If it's an occupational disease, the time starts to count when the employee knew or should have known that the injury is related to their employment. If you don't notify your employer of the injury, they can avoid liability.

However, there are exceptions to this general rule, like where:

  • The employer knew about the injury
  • You had reasonable cause for not reporting the injury; or
  • The insurance carrier doesn't contest the claim

Therefore, it'll be best to notify your employer early. You don't even have to wait until the thirty-day limit. Finally, it's noteworthy that you can submit the notice to your employer or your supervisor. 

What Percentage Does Workers' Comp Pay in Texas?

Injured workers who succeed in their claim can start receiving weekly compensation payments. If your employer denies your claim, they have to state the reason for the denial. Income benefits refer to any money you receive for a compensable injury. However, this doesn't include burial benefits, medical expenses, and death benefits.

If your workers' comp claim is successful, you can receive:

  • Temporary income benefits
  • Impairment income benefits
  • Supplemental income benefits
  • Lifetime income benefits

A deceased worker's family may also collect death and burial benefits. For temporary income benefits, the compensation claimant can receive 70% of the difference between their weekly wage and the amount they currently earn after the injury. Conversely, it'll be 75% if you earn less than $10/hour. If you become eligible for supplemental income benefits, you get 80% of the difference between your pre and post-injury wages.

Furthermore, lifetime income benefits are 75% of the amount you earned before your body damage. Death benefits can also reach 75% of the deceased worker's pre-injury weekly payments. Finally, if you reach maximum medical improvement (MMI), you can stop receiving compensation. MMI refers to the stage where the doctor believes that your condition can't improve any further.

How Do I Pay My Workers' Comp Lawyer?

Another issue Texas employees are concerned about is how much their compensation attorney will charge and how they'll pay. This is vital because an injured employee is already at significant financial risk. However, it would help not to bother about this. You typically won't have to pay your workers' comp attorney from your pocket. A Texas workers' comp lawyer will receive payment from your employer's workers' comp insurance.

Am I Eligible for Workers’ Comp in Texas?

Your lawyer's payment depends on the compensation benefits you receive. So, the higher your benefits, the more your lawyer gets. However, the Division of Workers' Compensation (DWC) must approve the attorney's fees. The DWC will consider your attorney's time and money investments in the case. Lawyers often have negotiable hourly rates, though.

Regardless, the DWC has a maximum rate of $150/hour for a lawyer. On the other hand, a legal assistant can get $50/hour. Finally, the maximum debit on your workers' compensation benefits is around 25%. You most likely won't have to pay any lawyer more than this. You can keep the rest for your lost wages, medical expenses, and other living bills.

What Disqualifies You From Workers Comp?

Can you be disqualified from receiving comp benefits for any reason? Yes, although the law protects employees, there are instances where you can lose your right to compensation. Usually, you can be disqualified through your actions.

Possible disqualifying scenarios include:

  • Intentional Hurt: If you intentionally tried to wound yourself or another employer, workers' comp law might disqualify you from receiving benefits. It may sound impossible, but workers can actually hurt themselves purposely. In such cases, it'll be unfair for the employer to pay for their actions.
  • Minor Injuries: If you suffered a slight injury, it might be unnecessary to apply for workers' compensation. If you didn't require or get medical care, you might not receive any benefits even if you file a claim.
  • Misleading Statements: If you submitted false information in your injury notice, you could also lose your benefits. For instance, if you reported the injury to be more severe than it is, your employer may validly deny your claim.
  • Intoxication: Workers' compensation is primarily for injuries from accidents. Therefore, any contributory negligence or personal contribution may reduce your chances of winning the claim. This includes where your accident was caused by the influence of alcohol or illegal drugs.

Can an Employer Terminate an Employee on Workers' Comp in Texas?

Many Texas workers are skeptical of filing a comp claim.. They're often scared that the business owner will terminate their employment as retaliation for seeking compensation benefits. Therefore, it's essential to know whether your employer, especially private employers have the right of termination of employment for workers who seek comp benefits.

Generally, Texas is an at-will employment state. So, employers can fire their employees for cause or without any reason at all. However, there are exceptions to this general rule. For instance, employers can't fire a worker just because they suffered a job injury or want compensation.

The Americans with Disabilities Act also prevents Texas employers from discriminating against disabled employees. So, a Texas business owner does not have the power to terminate employment where an employee:

  • Sought legal advice from an attorney or hired one
  • Filed for compensation income benefits in good faith
  • Agreed to testify or testifies in compensation claims proceedings

However, the employer may fire the worker where they:

  • Ignore safety training and rules
  • Failed to give notice of injury
  • Didn't inform the employer of material changes in their health or working ability

Furthermore, in some instances, the employer may not have a choice but to fire a worker. For example, the employer has to replace an injured employee after some time if their business must continue. This is especially so where they remain off-duty for a long time. Also, if there's no light-duty job for the worker, the business owner can lay them off.

However, in all these cases, the employees must continue receiving weekly compensation payments until they expire. Finally, an employee can sue their employer if they get fired for filing workers' compensation. If you succeed, you can claim special and punitive damages. The court may even reinstate you at the company.

Am I Eligible for Workers’ Comp in Texas?

Texas Workers' Compensation Attorneys Are at Your Service

Have you suffered a workplace injury or an occupational disease in Texas.? If so, you may be eligible for workers' compensation. However, workers' comp claims are slightly different from personal injury claims. Therefore, it'll be best to have an experienced workers' comp lawyer on your case.

Since workers' comp isn't mandatory in Texas, Calhoun, Meredith & Sims lawyers will first investigate whether your employer has Texas Workers' compensation coverage. Then, we'll determine whether you have a compensable injury. If you do, we'll initiate the process for your workers' comp claim. Therefore, it'll be best to call our law office today.

Consulta Gratis
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