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The US Bureau of Labor Statistics(BLS) reports that 5,333 workers died from a job injury in 2019. A workplace injury refers to an illness or injury that arises from an employee's work. In many jurisdictions, employers must hold a compensation insurance policy to compensate their employees when they sustain a work-related injury.
The work comp benefits usually continue till the injured worker reaches maximum medical improvement. The types of benefits an injured worker receives depend on the peculiarities of each case. Typically, compensation benefits cover medical benefits, loss of wages, burial benefits, and other fringe benefits. Your work comp attorney can help you get due compensation seamlessly.
Texas holds the spot as the largest, most populated state in the US after California. With about 29.36 million residents, it's pretty easy to imagine how dense their workforce is. You may also start wondering how effective the state's compensation laws are in providing for the needs of injured employees. We'd discuss that in this article.
As we earlier stated, many states mandate business owners and private employers to have a worker's compensation insurance policy. This policy provides work comp benefits (like income benefits) and covers their medical care for a period of time. However, an employer's responsibility to provide compensation depends on a lot of factors. These factors include the scope of employment, payroll size, type of business, etc.
Compensation liability also usually depends on the type of workers in question. Proprietors without employees don't need liability insurance coverage for their workers. Usually, work comp will only cover regular employees with a standard contract of employment or employees in construction businesses.
In some states, this excludes the following types of workers:
Unfortunately, however, Texas is the only state in the US that doesn't mandate employers to hold a workers' compensation policy. That means that Texas injured employees may find it difficult to file a comp claim for their personal injuries from a work-related accident. Texas workers' compensation laws only mandate work comp coverage for the employees of private employers contracting with the government.. Sometimes, a contractor can require workers' comp insurance coverage for independent contractors and subcontractors.
In summary, Texas employers have two options when it comes to insurance coverage for employees. First, they have the compensation insurance option. Here, they get some benefits if they decide to hold a work comp insurance policy. For example, they wouldn't have to worry about lawsuits from injured workers except in fatal cases due to the employer's negligence. Worker's compensation insurance also provides a defense against the assumption of risk and co-worker negligence claims.
The other options employers have is to get on without workers' compensation insurance. In that case, they have no legal protection against lawsuits. Furthermore, when they get sued, they cannot argue contributory negligence in court. Uninsured employers also have a series of legal requirements to comply with, including filing annual notices with the Division of Workers' Compensation (DWC).
Another significant difference between insured employers and uninsured ones is in their obligations. Asides, filing annual notices, uninsured employers must post notices in their offices and workplaces. They must also give written notifications to new employees, informing them about their insurance status. Employers with workers' compensation insurance coverage must report specific work-related injuries and wrongful deaths to their compensation insurance carrier.
Employers can provide workers' compensation for their employees in these three ways:
A self-insured group comprises different employers in the same industry. Instead of personal insurance, the group grants insurance policies to all its members collectively. Employers like to go for this kind of insurance because they usually receive them at reduced costs. That's because, as a group, the insurer's risks are shared among the policyholders in the group.
When employers take part in self-insurance, they set up a type of trust fund. They allocate employee and corporate contributions to their health plan to pay for any work comp claim. In clearer terms, this plan helps the employer save money and only pay for the claims their employees make.
However, note that employers who self-insure also take a high risk. The latter comes into play when an injured worker demands significant compensation. This is why the third option below is usually the best option for Texas employers.
Getting a workman's insurance coverage with a licensed insurance provider is the best plan for employers. Here, in the case of a workplace injury, the employer will contact the insurance carrier. The carrier will appoint an adjuster to investigate the claim and arrive at a decision.
Employers who work with a licensed insurance provider can always cover their employees. This is because insurance companies use the quote system. It means that the policy the employer buys depends on the industry they belong to, the propensity for injuries, and the number of employees they have.
Employers who don't have workers' insurance compensation coverage are called non-subscribers. Texas requires a non-subscribing employer to notify their employees that they don't have insurance coverage. As such, it should be easy to detect whether your employer has workers' compensation coverage or not.
However, you can't always bank on your employer to do the right thing. Sometimes, they may flaunt the rules and leave you wondering whether they're insured or not. If that's you, you can determine your employer's insurance status by doing the following:
The human resources department at your workplace exists for several reasons. One of them is to help you out with questions concerning workplace policies. The department can also provide information on office resources. You can approach them about the office's insurance status like you do when you ask about direct deposit sign-ups.
Sometimes, however, even the HR department may know little or nothing about the company's insurance. Other times, they may be dishonest about what they know. So, if you find out that speaking with HR yields no positive result, you should take the next step below.
You can check your employers' insurance status with Texas' insurance department's division of workers' compensation. It's easy. All you have to do is log on to their website and type your employers' details in the appropriate space provided. It will give you feedback on whether your employer is non-subscribing or not.
From ensuring that you don't make misleading statements to giving you insurance advice, your attorneys are always ready to help. You can also ask them about your difficulties with finding the employers' insurance status. They will provide solutions to your concerns.
Getting adequate compensation for your claim depends a great deal on your knowledge of insurance processes. If you're not conversant with Texas' insurance laws, you should seek insurance advice from a qualified Texas workers compensation attorney. Generally, however, you can take these steps when pursuing a workers' compensation claim:
The first thing to do after a work-related injury is to report it to your employer. This is a vital step that you mustn't miss because it significantly determines your claim's success. In fact, there's a time limit within which you must make the report or lose your rights to workers' compensation benefits.
After reporting your injury, you can file a work comp claim. The process starts by filling an Employee's Claim for Compensation with the DWC. After submitting the form, the DWC will contact your employers and their insurance companies.
When the insurance company receives the notification of your claim, they may decide to accept or deny it. Sometimes, even when they accept your claim, they may offer you meager settlement sums. As such, your lawyers will have to negotiate with them till they reach a mutual agreement. If your claims get denied, you can appeal the decision through DWC.
The claims process ends when both parties reach a mutual settlement and effect the necessary paperwork.
If your employer has workers' comp coverage, you may receive impairment income benefits and medical benefits for your medical care. In the case of a fatality, the deceased worker's eligible family members can get death benefits alongside legal benefits. The employer's insurance company will bear responsibility for the compensation costs.
However, it can be pretty confusing when dealing with a non-subscribing employer. If that's your situation, it'd be best to speak with a work comp lawyer. You'd likely have to file a lawsuit and prove your employer's negligence to get compensation for your injuries.
Work-related accidents can lead to devastating injuries. It's a difficult situation to be in, and you need all the help you can to get your injury benefit. Our work comp lawyers at Calhoun Meredith, will offer you all the support for your claims. Whether you're dealing with an insured employer or not, we'd ensure that you get your compensation as quickly as possible. Give us a call today.