What is Worker’s Compensation?
In Texas, worker’s compensation is given to injured workers through a state regulated insurance provider, if an employee is injured while working. Worker’s comp covers injuries that occur in and out of the workplace premises, if the worker is on the clock. Worker’s comp also provides benefits in the case of the development of a work-related illness. The insurance helps those who are injured to pay for hospital bills and can also provide extra compensation to cover lost wages.
A private employee in Texas has the ability to choose worker’s compensation insurance coverage, but they must let their workers know whether they have coverage or not. Worker’s compensation insurance coverage is not required by employers. These benefits are granted to a worker no matter the cause, just as long as the cause wasn’t deliberate or reckless manner by the employee himself. For example, work-related injuries that are not covered by worker’s comp include:
- The work-related injury is due to the employee’s own horseplay. When a worker is acting careless, they are endangering themselves. Therefore, the injuries that have occurred would be the worker’s own fault, due to their own recklessness.
- The injuries are a result from the worker’s intoxicated state. An employee at work who is under the influence of drugs or alcohol has the chance of being injured. If the employee was not under the influence of drugs or intoxicated, the injuries that occurred probably wouldn’t have happened. The worker’s negligence is the worker’s fault.
- The injuries are a result from the worker’s willful criminal actions. In the case that a worker has acted in willful criminal actions, the injuries are no longer considered work-related and are not eligible for worker’s comp benefits.
- Injuries are due to the worker having voluntary participation in off-duty recreational activities. In the case that the injuries occurred due to a recreational activity, even if the activities happened on the workplace premise, they are not eligible for worker’s comp, because they are not work related.
- The injuries are a result from the criminal actions of a third party. Even if the injuries are due to a third party criminal act, the injuries could not be eligible for worker’s comp benefits.
What types of Workers Are Eligible For Worker’s Compensation?
Worker’s compensation in Texas provides multiple benefits to injured workers or their family members. The benefits include:
- Medical Benefits – An injured employee has the rights to medical benefits that allow the injured worker to be able to pay any medical expenses that are associates with treatment to the work-related injury.
- Income Benefits – In Texas, an injured employee has the ability to gain four different types of “income” benefits.
- Temporary Income Benefits – When an employee has had to miss seven or more days of work, due to a work-related injury, Temporary income benefits are paid. In other words, temporary income benefits are wage replacement benefits.So they are used to help replace an injured employee’s wage. Temporary income benefits are also known as wage replacement benefits.
- Impairment Income Benefits – In Texas, an injured employee can receive impairment income benefits if the employee has suffered permanent impairment due to their work-related injury.
- Supplemental Income Benefits – Supplemental income benefits are available for injured workers based on their impairment rating and other qualification criteria.
- Lifetime Income Benefits – In some cases, an injury could be so serious that the injured worker could be eligible for lifetime income benefits.
- Death Benefits – In the case that a worker has died due to a work-related injury or illness, the remaining family members could be eligible for death benefits.
- Burial Benefits – Whoever pays for the burial of the worker may also obtain burial expenses for the departed worker.
Can I Choose My Own Doctor?
An injured worker can choose their own medical professional, so long as the doctor is chosen through the Texas Division of Worker’s Compensation and is licensed as a workers’ compensation doctor. Usually, a list is provided of the designated doctors by the injured worker’s employer. However, if the boss is unable to provide this list, an injured worker can search for a worker’s compensation designated medical professional to give them medical treatment for their work-related injury or illness.
If I Need Help With My Worker’s Compensation Claim, Where Can I Turn?
Injured employees have three options when they need assistance in dealing with the Texas worker’s compensation system. These three main options are: talk to an experienced worker’s compensation attorney, get in touch with a staff member at the Texas Department of Insurance Division of Worker’s Compensation, or attempt to get help from the Office of Injured Employee Counsel, if the injured employee doesn’t already have a worker’s compensation lawyer. The injured worker is able to get help from either option with:
- A comprehensible understanding of the workers’ compensation system
- Assistance on the usage and navigation through the Texas worker’s compensation system
- Answers to questions that injured employees may have about claims, how to file a claim, claim disputes, or how to resolve a claim dispute; and
- Assistance on how to handle when an injured employee’s claim is denied.
Is Worker’s Compensation Claim Information Kept Confidential?
100% confidential, an injured worker’s workers’ compensation claim info is only available to those who are handling the claim. An injured employee is able to designate an individual, like a spouse, to be authorized to talk to the Texas Division of Worker’s Compensation in regards to the injured employee’s worker’s compensation claim.
However, potential employers are able to see in a background check whether a prospective hire has had an worker’s compensation claims in the past. Employers are able to see if a prospective hire has reported two or more work-related injuries in the past five years.
Is Worker’s Compensation My Only Means of Recovery?
Injured employees can look for compensation from multiple other sources in certain cases when they are injured or have become ill due to them performing their job functions. For example, if a third party is responsible for causing a work-related injury or ailment, an injured employee might have to claim a personal injury claim against the liable third party. A third person liability lawsuit is where an injured employee can recover lost wages for an injury or ailment, if the damages are beyond compensation, in situations like mental anguish, pain and suffering, etc.
Is My Boss Allowed to Treat Me Differently, Discriminate Against Me, or Fire Me?
As a general rule, a boss should not treat a worker any differently after the injured worker has filed for worker’s compensation; though, if this occurs, there are legal provisions in place that prevent employers from such discrimination. A wrongful termination lawsuit could be called for if an employer terminates an injured worker because they had filed a worker’s compensation claim. So long as the reason is not one that is protected against by law, Texas employer’s may terminate their employees for any reason, due to the fact that Texas is an at will employment state. Though an employer can fire an individual because the workplace is slow, or if the injured worker cannot perform their work duties because of the work-related injuries. In Texas, bosses must legitimize their reason behind terminating an injured worker.