Houston Work Injury Lawyers

Helping Injured Workers Secure Fair Compensation

The Division of Workers’ Compensation of the Texas Department of Insurance conducts a yearly survey to track the number of nonfatal work injuries and illnesses among employees of privately owned organizations. In 2022, their survey revealed that 178,800 workers became injured or ill, with the highest incidence of nonfatal cases being among those employed in the trade, transportation, and utilities areas (3.0 cases per 100 full-time workers), followed by educational and healthcare services (2.7 cases per 100 full-time workers).

In Texas, injured workers may be covered by workers’ compensation insurance, which may provide benefits in the event of a work-related injury or illness. The attorneys at The Alfred Firm explain what rights you may have as an injured worker in Texas and how an attorney can help you secure fair compensation for a work injury. If you have questions about your specific case, reach out to The Alfred Firm by calling our office in Houston at 713-489-1875.

What is Workers’ Compensation?

Workers’ compensation is a type of insurance that provides financial and medical benefits to employees who have sustained work-related injuries or illnesses. This system is set up to provide support to injured workers as they recover from a job-related illness or injury. Worker’s compensation typically covers medical expenses and a portion of a worker’s regular wages and may cover additional costs related to the injury or illness, such as rehabilitation. Additionally, it may also provide compensation for permanent disability or death in the event of a fatal injury.

Workers’ compensation can benefit both employers and employees. Employers who carry workers’ compensation insurance are protected from being sued by their employees in the event of a workplace injury. This coverage also helps employees get access to the medical care and financial support they need to recover from their injury or illness without having to go through a lengthy litigation process.

What Does Worker’s Compensation Cover?

Workers’ compensation may cover medical expenses related to workplace injuries, such as medical bills, prescriptions, and costs associated with physical therapy and rehabilitation if applicable. Workers’ compensation also provides coverage for a portion of an employee’s weekly wages for the weeks the employee has been unable to work.

Additionally, workers’ compensation may provide compensation for disability and may also provide death benefits to the surviving family members of a worker who may have suffered a fatal work injury. These benefits can include funeral costs, burial costs, and lost wages due to the death of a family member.

In some cases, workers’ compensation may also provide benefits for vocational rehabilitation when an employee’s injury results in permanent partial disability and their condition prevents them from returning to the same job position they had before the injury. In some cases, workers may get benefits to assist them with the costs of preparing themselves for a new career, such as job training or vocational programs.

Is Everyone Eligible for Worker’s Compensation Coverage?

In Texas, employers are not required to carry workers’ compensation insurance. For those employers who do offer coverage, workers’ comp insurance usually applies to workers who have an employee status, including full-time, part-time, and temporary employees. In contrast, those workers with a different status, such as independent contractors, family members of the business owner, and volunteers, are not typically covered by workers’ compensation. Additionally, certain types of workers are exempt from workers’ compensation coverage, such as agricultural workers, domestic workers, and casual workers in a domestic setting.

Workers’ compensation also does not cover employees who are injured while engaging in criminal activities or while participating in recreational activities not related to their jobs. It is also worth mentioning that self-inflicted injuries or injuries that occur while an employee is under the influence of drugs or alcohol are not usually covered by workers’ compensation.

What Is the Process to File a Worker’s Compensation Claim in Texas?

If you are injured at work, it is crucial to seek medical help as soon as possible, even if you do not believe your injury is serious. Get examined by a doctor or healthcare professional, and be sure to inform them that your injury is work-related. After that, the next step is to notify your employer of the injury or illness. This step is extremely important and should be done as soon as possible after the incident occurs, preferably in writing. The employee should provide the employer with information about the injury, such as how and when it occurred. The employer should then create an injury report, notify their insurance company, and inform you of the steps you need to take to file your claim with their insurance company.

After the claim is filed, the insurance company will review the claim and determine if it is eligible for benefits. You may be asked to submit evidence to support your claim and document the extent of your injury, such as medical reports and test results. The insurance company will investigate the claim and make a decision based on the evidence. If the claim is accepted, the insurance company will inform the employee of how and when they can expect to begin receiving payments and whether they need to continue their treatment with a specific doctor referred by the employer or insurance company. Be sure to retain a copy of all documents related to the claim for your records. If you are not sure about the steps required to file a workers’ compensation claim for your case, you may want to contact a workers’ compensation attorney. An attorney can answer your questions and assist you with the process of filing a claim or communicating with the workers’ compensation insurance company.

What Happens if the Accident Was the Worker’s Fault?

Workers’ compensation provides coverage for employees regardless of who was at fault for the accident. No-fault coverage is one of the many advantages of workers’ comp insurance – an employee can be covered even if the employee was the one responsible for the injury.

However, as mentioned previously, there are some circumstances where the employee may be excluded from coverage, such as when the employee’s injury was due to intoxication or horseplay or took place outside of their work activities. In addition, the insurance company may deny coverage if the employee was engaged in illegal or criminal activities at the time of the injury. Coverage may not be applicable in cases where the employee may have been intentionally trying to harm themselves or another person.

What if My Employer Does Not Offer Worker’s Comp Coverage?

In the state of Texas, employers can choose to either provide workers’ comp coverage or opt-out from providing coverage. Employers who choose not to provide coverage are referred to as non-subscribers. Non-subscriber employers are not required to provide workers’ comp benefits, but they must comply with certain regulations. For instance, non-subscriber employers must provide employees with written notice of their non-subscriber status and keep records of employee injuries. Additionally, non-subscriber employers must post a notice of their non-subscriber status in a conspicuous location in the workplace.

Worker’s compensation insurance protects employers from being sued by an injured employee seeking damages compensation. However, non-subscribers do not have this type of protection. In other words, in the event of an injury, non-subscriber employers can be held liable for damages. This means that if an employee is injured on the job, the employer can be sued and held responsible for medical expenses, lost wages, and other damages resulting from the injury. If you were injured or developed a work-related illness and your employer is a non-subscriber, you may want to consult an attorney to see if filing a civil lawsuit against your employer may be a feasible option for you to recover compensation for your injury or illness.

Can My Employer Fire Me Because I Filed for Worker’s Compensation?

Many workers choose not to file a workers’ compensation claim and keep their work injuries hidden from their employer for fear of losing their jobs for filing a claim. However, it is important to understand that it is illegal for an employer to fire an employee just because the employee has submitted a workers’ compensation claim. Employers are prohibited from retaliating against employees who engage in protected activities such as filing a claim, and if an employee is fired for this reason, they may be able to sue their employer.

However, while an employee cannot be fired for filing a worker’s comp claim, they still may be fired for other reasons. Texas is an at-will employment state, meaning that both employers and employees may initiate and terminate an employment relationship at any point and for any reason, as long as the employer is not engaging in any discriminatory or retaliatory practices.

Employers are allowed to terminate employees for legitimate reasons, such as inadequate performance, attendance, attitude, failure to meet job expectations, or misconduct. Employers are also allowed to terminate employees for economic reasons, such as layoffs or downsizing. If you believe that you have been wrongfully terminated after filing a workers’ compensation claim, consult with an attorney to determine the best course of action for your case.

What Can I Do if My Worker’s Comp Claim Is Denied?

If you filed for workers’ compensation benefits in Texas and your claim was denied, you should know that you still have options, and a denial does not mean the end of the road for your claim. First, many workers’ compensation claims are denied for missing or incorrect information. It is quite common for employers to misunderstand details about the worker’s injuries or make mistakes when submitting the required forms to their insurance company. If your claim has been denied, try talking to your employer about it and see if you can resolve things through a simple conversation. Sometimes, you just may need to send in more information, such as additional medical records or further details about your injury and how it occurred.

If informal conversations fail to bring you any positive results, you may want to contact a workers’ compensation attorney at this stage. Your attorney may reach out to the insurance company and try to work out a compromise with them. Since many insurance companies would rather avoid the time and expenses associated with more formal proceedings, they sometimes become more willing to cooperate with you once they realize you have legal representation. If your claim is still being denied, your attorney may suggest scheduling a benefit review conference.

A benefit review conference is still an informal meeting in which all parties (you, your attorney, and the person who represents the insurance company) gather to try to work out a solution. If the meeting fails and no agreement is reached, the case can then move on to a more formal setting and be resolved through arbitration or through a contested case hearing. If you are still having no success, filing a civil lawsuit may be your next option. Your attorney can advise you on whether civil litigation may be appropriate for your case.

What Happens if My Work Injury Was Caused by an Independent Contractor or Third Party?

If an injured worker believes that their work injury was caused by an independent contractor or third party, they may be able to file a personal injury claim against the contractor or third party. This claim can seek compensation for the injured worker’s medical bills, lost wages, and any other damages that resulted from the injury. If the third party has liability insurance coverage or any type of business insurance, the injured worker may be able to file an insurance claim.

If no insurance is available, the injured worker should consult an attorney to determine if they have enough evidence to initiate a lawsuit against the third-party responsible for their injuries. It is important to understand that, in order to file a personal injury lawsuit, the injured worker must be able to prove that the contractor or third party was negligent in some way. This means that the contractor or third party must have failed to act in a reasonable manner that would have prevented the injury. Additionally, the injured worker must be able to prove that the contractor or third party’s negligence was the direct cause of their injury.

If you were injured in a work accident in which a third party may have been at fault, it is crucial to understand that filing a personal injury claim against a contractor or third party does not void your right to workers’ compensation benefits from your employer if your employer provides coverage. Injured workers are still entitled to receive workers’ compensation benefits regardless of whether they file a personal injury claim against a third party. While an injured worker cannot sue an employer covered by worker’s comp insurance, suing a third party or filing a third-party liability claim may allow the worker to recover additional damages that they may not have been entitled to under workers’ compensation, such as pain and suffering.

Why Should I Hire an Attorney for My Workers’ Compensation Case?

In a perfect world, an injured worker would be able to file a claim and receive their check a few short weeks later without any undue headaches. Unfortunately, the reality is often very different, and injured employees are made to jump through hoops and deal with what seems to be an endless amount of paperwork and red tape, only to have their claims denied or be paid much less than what they deserve.

When you seek the help of an experienced workers compensation attorney shortly after your work injury, you can increase your chances of receiving the correct benefits amount without having to deal with the stress that often comes with the process of filing a claim. Your attorney can guide you through every step and facilitate communication between you and the insurance company, letting them know you have someone who will protect your interests no matter what – even if that means taking the case to the courtroom. If your employer is a non-subscriber, hiring an attorney for your case becomes even more crucial.

At The Alfred Firm, injured workers in Houston and surrounding areas can get the strong legal representation they need with the respectful and compassionate service they deserve. If you have been hurt at work or developed an illness as a result of your work activities, contact the Houston workers compensation attorneys at The Alfred Firm by calling 713-489-1875 and requesting a free consultation to discuss your case and learn more about how we can help you.