Suffering an injury on the job can be a stressful and overwhelming experience. In addition to dealing with physical pain and recovery, injured employees often worry about keeping their job, covering medical expenses, and securing financial support during their time away from
work. While Texas’ workers’ compensation system is designed to help injured employees recover medical benefits and lost wages, navigating the claims process is not always straightforward. Understanding your legal rights can help ensure you receive the compensation you deserve.
Workers’ compensation (or “workers’ comp”) is a state-regulated program that provides
financial and medical benefits to employees who suffer work-related injuries or illnesses. In
most cases, when an employee is hurt on the job, they cannot sue their employer as long as the
employer is enrolled in workers’ compensation insurance.
Workers’ comp benefits may include:
● Medical coverage for injury-related treatment
● Income benefits for lost wages during recovery
● Death and burial benefits for families of deceased workers
Unlike most states, Texas allows employers to opt out of the workers’ compensation system.
These non-subscriber employers are not protected from lawsuits, meaning injured employees
may have the right to file a personal injury claim against them.
Workers must determine whether their employer carries workers’ comp insurance or if a
lawsuit is necessary to seek damages. The process for filing a claim depends on whether the
employer participates in the workers’ compensation system or is considered civilly liable
for workplace injuries.
Workers’ comp claims in Texas are regulated by the Division of Workers’ Compensation
within the Texas Department of Insurance. To qualify for benefits, employees must follow a
strict claims process:
1. Report the injury – Employees must notify their employer within 30 days of the injury
or discovery of a work-related illness.
2. File a workers’ comp claim – A formal claim must be submitted to the Division of
Workers’ Compensation within one year of the injury.
3. Claim review by employer’s insurance – The employer’s insurance provider will
approve or deny the claim based on their investigation.
4. Appeal process for denied claims – If the claim is denied, employees have the right to
challenge the decisionthrough the Division of Workers’ Compensation.
Missing these deadlines or failing to submit proper documentation could result in denied
benefits. A knowledgeable attorney can help injured employees navigate the process and
challenge unfair claim denials.
Certain industries pose a higher risk of workplace injuries, but even employees in low-risk jobs can suffer serious accidents. Some of the most common workers’ compensation claims
involve:
● Machinery accidents
● Exposure to harmful chemicals or substances
● Overexertion from repetitive tasks
● Fires or explosions
● Work vehicle collisions
● Electrocution
Regardless of the type of workplace injury, employees must prove that the injury occurred during the course of their employment to qualify for benefits. An experienced legal professional can assess the strength of a claim and provide guidance on the best course of
action.
While workers’ compensation is intended to protect injured employees, the claims process can be difficult to navigate, especially when employers or insurance companies attempt to deny
or minimize benefits. Legal representation can help injured workers:
● Determine if their employer carries workers’ comp insurance or if a lawsuit is an option
● Ensure all deadlines are met and proper paperwork is filed
● Challenge unfair claim denials through the appeals process
● Negotiate with insurance providers for full and fair compensation
If you or a loved one has suffered an injury at work, understanding your legal options is essential. Seeking guidance from experienced workers’ compensation attorneys can help
ensure that you receive the benefits and financial support you need.
Consider consulting with a qualified legal professional to discuss your case and explore the best path forward.
