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Workers’ Compensation FAQs in Sugarland

Sugarland TX Workers Compensation FAQs

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 compensation also covers any situation in which an employee may develop a work-related illness.

This insurance provides compensation for hospital bills that may have incurred by the injured worker, and can also provide the injured worker with some type of temporary compensation for lost wages.

Private employers have the option to provide workers with worker’s compensation insurance coverage in Texas, and they must let workers know whether or not they have coverage.

It is not required for employers to have Worker’s Compensation Insurance coverage.

Worker’s comp benefits are always granted, no matter who cause the accident, unless the worker is responsible for causing the injury in a deliberate or reckless manner.

For example, work-related injuries that are not covered by worker’s comp include:

  • Injuries occur because of the worker’s horseplay.
  • When a worker is acting careless, they are endangering themselves.
  • This means that any injuries that have happened, it is the employee’s fault because of their carelessness.
  • The injuries are a result from the worker’s intoxicated state.
  • Chances of an injury are high if an employee are under the influence of drugs or alcohol.
  • 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. If the employee is injured because of their own willful criminal actions, they will not be eligible for worker’s compensation 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.
  • Injuries are due to criminal actions of third parties. 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?

Texas worker’s comp offers many different kinds of benefits to aid injured workers and their family.

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. Throughout Texas, an injured worker is qualified for four different kinds 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. An injured employee in Texas could obtain impairment income benefits in the event that he has suffered a permanent impairment as a result 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 extreme cases, where the injured employee has passed away as a result of the injury or ailment, the employee’s family may be able to receive death benefits.
  • Burial Benefits. If an individual pays the burial expenses of an injured employee who passed away due to their work-related injury, burial benefits may be available.

Can I Choose My Own Doctor?

Injured employees may choose their own doctor, as long as, the doctor they choose is designated by the Texas Division of Worker’s Compensation as a workers’ comp doctor.

There is a list of designated doctors typically provided by the injured employee’s boss.

In the case that the employer is not able to supply this list, the injured employee can look for any worker’s compensation designated doctor to give them the proper medical treatment they need for their work-related injury or ailment.

If I Need Help With My Worker’s Compensation Claim, Where Can I Turn?

An injured worker has three main choices when they need help with the Texas worker’s compensation system.

An injured worker can either talk to a worker’s compensation lawyer, contact the Texas Department of Insurance Division of Worker’s Compensation and speak to a staff member, or seek help from the Office of Injured Employee Counsel if the injured individual hasn’t already talked to a worker’s compensation attorney.

No matter the choice, each option is able to provide the injured worker with:

  • A graspable understanding of the worker’s compensation framework
  • 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
  • Guidance on what to do after an injured worker’s claim is denied.

Is Worker’s Compensation Claim Information Kept Confidential?

An injured employee’s claim info is kept 100% confidential, with only those who are directly involved with the case being able to access this information.

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.

Future employers are able to look up in background checks whether a potential hire has reported any work-related injuries 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?

Sometimes, injured worker may need seek compensation from other sources if they have injured themselves at work.

In the case that a worker is injured due to a third party, an injured employee may have to file a personal injury claim against the liable third party.

In a third person liability lawsuit, an injured employee can look for damages that are beyond compensation for hospital bills and lost income (where the injured employee can recover by filing a worker’s compensation claim), and can look for noneconomic damages for injuries that are difficult to put a financial value on, such as mental anguish, pain and suffering, etc.

Is My Boss Allowed to Treat Me Differently, Discriminate Against Me, or Fire Me?

There are certain legal provisions put in place to protect individuals who have filed worker’s compensation, to be discriminated against, however, as a general rule, an employer should not treat their employee any differently after they have filed worker’s compensation.

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.

Thus, the employer may fire the injured employee, if he cannot perform his job activities anymore due to the injury, or if business is slow.

In Texas, bosses must legitimize their reason behind terminating an injured worker.

Can I File For Workers’ Compensation If I’m Only Part Time in Sugarland?

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