If you were hurt on the job, you could be entitled to money to pay for your injuries, lost wages and future medical bills.
Additionally, if you were hurt by a third party while at work, Texas allows you to make a workers' compensation claim AND a claim against the third party, meaning there are two avenues for you to recoup the money you lost in the accidents.
How Does Workers' Comp Work in Texas?
In Texas, not all companies offer workers’ compensation. Only state-run organizations or companies under government contract are required to provide this type of insurance for their employees. Private companies have the option to provide it.
If your employer does not offer workers’ comp, you should have received a written statement that makes this clear when you were hired. Your employer is also required to display notices of non-coverage throughout the workplace and file an annual notice with the Texas Department of Insurance.
If your employer does provide workers' comp, this protects both you and your employer in the event that you are injured on the job.
What Does Workers' Comp Cover?
Workers’ comp pays for four items if an employee is injured on the job:
- Lost income and wages
- Medical and treatment costs
- Burial and funeral expenses
- Death benefits and lost wages to an employee’s surviving family
An employer may not be held responsible for any other damages or costs incurred due to the injured, since workers' compensation is designed to protect employers from personal injury lawsuits.
What Does Workers' Comp NOT Cover?
Specifically, workers’ comp will not pay for on-the-job injuries that are considered:
- Self-inflicted or intentional
- An act of God
- Inflicted by someone else for a personal, non-work related reason
- A result of drug use, intoxication or roughhousing
- A result of participation in a non-required off-duty social or recreational event.
Making a Workers Comp Claim in Texas
If you have been injured on the job and plan to seek workers’ comp benefits, you are legally obligated to notify your employer within 30 days of the injury.
Then, you must fill out DWC Form-041 (the Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease) and send it into the Texas Department of Insurance, Division of Workers’ Compensation.
You have one year to do so.
To ensure you have taken the proper steps and to maximize your benefits, it’s important to seek legal counsel before filing these forms. A mistake on your filing could cause a hold up in your claim and delay your benefits.
You Can't Use Any Doctor You Want
In order to receive medical benefits of workers’ comp, you are required to use an approved doctor for your treatment. If your employer provides health benefits through a workers’ comp network, they are required to provide you with a list of approved medical professionals from which you can seek care. If they do not, you will need to locate a workers’ comp health care provider in your area.
In the future, if you plan to seek care from another provider, you must first get this approved by your employer or a Texas Workers’ Compensation panel. Additionally, you may be required to attend what’s called a “designated doctor examination” on occasion. This is performed by a Department of Workers’ Compensation-selected physician who will make recommendations as to your condition and care.
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