A workers comp attorney, also known as, a personal injury lawyer, concentrates on helping workers collect workers comp insurance from a work related accident that sustained injuries on the job. When a workers comp attorney begins helping you, they will look at the workers comp policies and then they see whether or not there is a conflict between the employee and the employer and then they will negotiate directly with the workers comp insurance companies to make sure that there is a fair workers comp settlements.
A workers comp lawyer is also known as an injury attorney, employment attorney, or accident attorney. In Bexar, some of the best and biggest law firms can only have a one or two personal injury lawyers that specialize in workers compensation insurance claims and personal injuries. Not to reiterate the point, but a workers comp lawyer can also specialize as a car accident attorney that can represent victims of a car accident who sustained injuries.
Going back to work related injuries
A workers compensation lawyer can determine if an injured worker has a chance to benefit from a workers’ compensation insurance in the event that they have to look for medical treatment for their sustained injures and recovery period. In the most difficult claims, a workers compensation board may be called in to help settle the claim. Workers’ compensation is a type of insurance that most employers are required to provide for their workers in Texas. Workers’ employment lawyers are well trained in workers comp insurance and can help employees get reasonable and fair workers comp settlements.
The Rights of Injured Workers To Have Workmans Comp Insurance
In Texas, a worker has certain rights when they have sustained an injury at work, in according to the Texas workers’ compensation system. These rights are:
1. The right that at any time during the workers’ comp claims process, the injured worker can be assisted by a workers’ comp attorney;
2. The right to get aid from the Office of Injured Employee Counsel if the injured worker has not already had a workers comp lawyer;
3. Nevertheless in regards to the fault and dependent on eligibility, the injured worker might have the right to financial and medical benefits through workers’ compensation (some exceptions may apply), and surviving family members can have the right to burial ad death benefits if the injured worker has passed away because of the work related injury;
4. The right to medical care in order to treat the workplace injury or illness for the amount of time that the treatment is needed;
5. The right to recover compensation benefits for the work related accident or sickness;
6. The right to disagree resolution regard claim in concern to death or income benefits.
7. The right to pick a doctor within the Workers’ Compensation Health Care Network; and
8. The right to have all workers’ comp claim info kept confidential.
The Responsibilities of Injured Workers
Under laws in regard to workers compensation in Texas, workers that have been injured have certain responsibilities. Texas state laws say that an employee must fulfill the following responsibilities before they are eligible for workers’ compensation benefits:
1. The responsibility of reporting your work-related sickness or accident injury to your boss within 30 days of the sickness or injury;
2. The responsibility of finding out if the employee is a part of the Workers’ Compensation Health Care Network;
3. The responsibility of determining how to get medical care if the employee belongs to a political subdivision, which can be work for a school district, a city, or a county;
4. The responsibility of contacting the medical doctor about the injury or ailment and whether it is work-related;
5. The responsibility of carrying out and presenting an Employee’s Claim for Compensation for a Work-Related Injury or Occupational Claim Form to the Texas Division of Workers’ Compensation;
6. The responsibility of providing up-to-date contact information to the Texas Division of Workers’ Compensation;
7. The responsibility of informing the workers’ compensation insurance provider and the Texas Division of Workers’ Comp if the Injured employee’s status has changed;
8. If the injured employee passes away because of their work-related injury or ailment, the remaining family members have the responsibility to complete and submit a Beneficiary Claim for Death Benefits to the Texas Division of Workers’ Compensation within exactly one year from the death of the employee; and
9.The responsibility of being honest and not sending in a fraudulent or frivolous claim.
Types of Workmans Comp Insurance Benefits
Workers’ compensation is available in four different types of benefits in Texas:
- Medical Benefits – Medical benefits allow injured employees to compensate for the medical treatment needed to treat only their work-related accident injury or ailment. Restrictions are in place while obtaining medical assistance, such as having to acquire medical care within a workers’ comp insurance provider’s service framework, as well as, choosing a medical physician from a list of network care providers that are prescribed (in the situation where you do need emergency treatment due to a life threatening work-related injury or ailment, you may find care in an emergency care facility).
- Income Benefits – Injured workers in Texas are eligible for four different types of “income” benefits.
- Temporary Income Benefits (TIBs) – In the case that a worker has missed seven or more days of work, Temporary income benefits will be compensated because of the work related injury or sickness. An injured worker can be eligible for temporary income benefits as soon as they have missed eight days of work. The total amount paid for TIBs is 70 percent of the entire difference between the worker’s typical weekly wage, as well as, any wages that the injured worker could be able to earn after their work related accident. There is still a possibility for the injured worker to be compensated if the employee returns to work, but this is in a modified position that would accommodate their injury. If the worker is in a modified position and receives a reduced wage, TIBs can continue. As a general rule, TIBs will conclude after 104 weeks of payment, or as soon as the employee has reached their maximum medical improvement, which is determined by the worker’s health care provider. TIBs are also considered wage replacement benefits.
- Impairment Income Benefits (IIBs)In Texas, when the worker has endured a permanent impairment as a result of the work-related injury, they can receive the impairment income benefits. Once the injured employee has reached their maximum amount of medical improvement, or that the best level of recovery that is possible, a health care provider can ascribe the injured employee an impairment rating.
IIBs are eligible on the basis of the worker’s impairment rating. Three weeks of IIB remunerations are paid based on the percentage of the employee’s impairment rating. 70 percent of the employee’s average weekly wage, or 70 percent of the state average weekly wage are paid as IIBs (with the former serving as a cap on IIBs).
- Supplemental Income Benefits (SIBs) – In any case where a worker has an impairment with a rating of 15 percent or more, did not return to work because of their impairment, returned but can only make less than 80 percent of their pre-work injury average pay, is looking for a new job, and didn’t receive the IIBs in a lump sum benefit, the injured employee may be eligible for supplemental income benefits.
The SIBs will reimburse about 80 percent of the differences between the total worker’s pre-injury average weekly wage and the worker’s post-injury weekly pay. SIBs have to be reapplied for every quarter after the IIB has been terminated, and they are paid on a monthly basis. SIBs will be closed 401 weeks (estimated 7.5 years) after the employee suffered the injury.
- Lifetime Income Benefits (LIBs) – Sometimes injuries could enable to injured worker to gain lifetime income benefits. For example:
- A loss of both feet above the ankle, or both hands above the wrist, or any combination;
- A combination of paralysis between two limbs;
- The worker becomes mentally disabled or insane, due to a traumatic brain injury; or
- In the case of third degree burns that either cover 40 percent of the body and require grafting, or covering both hands and the face.
Each of these injuries could enable a worker to be eligible for LIBs. Paid at 75% of an injured worker’s weekly salary, LIBs are subject to a 3% raise, or increase, after each year. LIBs can only be applied through with a written request made with the workers’ comp insurance carrier.
- Death Benefits – When a worker passes away because of a work-related injury, the decedent’s family (i.e., a surviving spouse, minor children, dependent grandchildren, and other dependents) may be qualified for death benefits through workers’ compensation. Death benefits will be paid at 75% of the deceased worker’s average weekly wage, subject to maximum and minimum death benefit limits. The spouse of the deceased is qualified to receive death benefit payments for the rest of their lifetime, unless they decide to remarry. Until a child reaches 18, they can receive death benefits, or 25 if they stay enrolled in an official educational institution. Once the older child is ineligible to receive benefits due to their age, the death benefits are redistributed to the younger children. If grandchildren are at least 20% dependent of the person who passed away, they can receive benefits until they are 18, unless their parents are eligible for these benefits. Grandchildren who have exceeded the 18 year old age limit may still gain benefits, but only 364 weeks’ worth of such benefits. If there are no surviving spouse, children or grandchildren, a non-dependent parent can gain death benefits, but this is limited to 104 weeks of benefits.
- Burial Benefits – Whoever pays the burial fees for the deceased employee, can receive burial expenses. Burial benefits are paid out as recompensation.
Can I Choose My Own Doctor?
In Texas, in order for the employee to obtain workers compensation benefits, a wounded worker must select a medical professional so that they may get a medical examination to decide on the eligibility of the worker and whether they can get workers’ compensation benefits. The medical professional has to be designated by the Texas Department of Insurance Division of Workers’ Compensation. Many times, employers’ have information for doctors on how to find a designated medical physician within the employers’ workers’ comp insurance providers’ health care system. Injured workers can request this information from their bosses.
Once the injured worker is in contact with a treating expert, they will have the ability to lead the injured worker to other in-system specialists or authorities as required. In certain situations a boss might not have a care provider obligation; in this case the injured employee must find a designated doctor. In such situations, the best place to look is the employee’s regular care provider. As long as the employee’s typical health care provider works well with workers’ comp patients then the typical health care provider should be sufficient. If not, the employee can discuss with their regular health care provider for a recommendation.
When all else tends to fail, a workers’ compensation chosen doctor can be found on the internet or the telephone directory. If there is an emergency, an injured worker may seek care for emergency care from a hospital or doctor. Once any initial life-threatening risks or trauma are lessened, the injured worker must find and visit a chosen workers’ compensation treating doctor for all further treatment for the work-related injury or ailment. An injury attorney shouldn’t be sought after, until you have had your emergency medical and urgent follow up.
You should wait before you talk to a Bexar personal injury attorney or workers comp lawyer because of two reasons. The first is simply because you don’t want to lose precious time in regards to getting medical treatment. While the first reason is obvious, the second is not. Waiting to see what the doctors will say or waiting to see the amount of bills you start to rack up before you contact a workers comp attorney you will have more info in the end, to give to the workers’ comp attorneys that you will interview. The information will help you in the long run, to make a stronger case in your favor.
Regarding a Work Compensation Case What Is The Responsibility Of A Designated Doctor?
Adding to a workers’ comp attorney defending your workers’ compensation claim, a designated doctor is brought in to perform a medical exam and provide you with a recommendation about the work-related condition. Also, a designated doctor may be required to help out in regards to resolving a dispute concerning a work related accident. As well as, the designated doctor might be called on to:
- Merge and review any existing medical records and info in relation to the work-related injury or sickness
- Execute exams, scans, tests, etc., as per necessity to fully assess the work-related injury
- Decide when the injured laborer has obtained a max amount of medical improvement, and when this amount was reached
- Additionally, once the maximum medical improvement is reached, assigning an impairment rating; and
- Produce and submit a thorough medical exam report for the injured individual to the Texas Division of Workers’ Compensation and insurance provider within the seven days deadline of the medical exam, which should include a narrative report and any other documentation concerning the injured workers’ impairment rating.
Going Back to Work After An Injury Workers Compensation Forms
The Ideal situation for an injured laborer is to receive workers’ compensation benefits for the work-related injury or sickness until the laborer is fully ready and well-enough to return back to their job. This ensures that that worker is productive and engaged in their work, and also reduces any costs associated with the worker’s injury and time out of the workplace. Sometimes, there is pressure from the manager to return to work earlier than recommended by the doctor, this sounds odd, but Bexar attorneys have had to interfere with disputes between employees and employers so that the employee can rest and be allowed the appropriate time to recover. After the worker has finished recovering from a work-related accident, the employee is then able to go back to work.
The worker does not have to be fully recovered in able to return to work. Injured employees who are almost recovered, but are eager to go back to work, should consult this possibility of going back to work early with both their employer and designated doctor. Before going back to the workplace, the employee should understand any kind of instructions related to returning back to work and the proper workers comp forms. The laborer should ensure that he reads the “fine print.”
It’s also imperative to check with the workers compensation lawyer that took on the case and to make sure that the employee is not in danger of losing his workers compensation insurance due to agreeing to accept a temporary position offered by the manager for the injured worker. There typically is at least some degree of workers’ compensation available until the laborer has made a full recovery. In some cases, bosses will have a Return to Work Program which are designed to help injured workers in their return to work by providing them with short-term assignments or modifications to their original job tasks to help them in their time of recovery. In order to help the employee get back into the workforce and provide a sense of being productive, stable, and promoting normalcy, these programs give the idea that some work, is better no work. Workers’ comp pay can then be reduced or suspended on the account of whether the employee is working in a limited capability when returning to work. A worker’s benefits can be lost only dependent of the eligibility in the first place, as well as the wage difference between their original wage and the post-injury wage.