Workers Comp Attorney Houston
A workers comp attorney, often referred to as a personal injury attorney, specializes in helping workers collect workers compensation insurance from work related injuries sustained while working on the job. The work injury lawyer first reviews the workers compensation policy and then if there is any conflict between employees and the employers, the workers comp attorney will negotiate directly with the workers compensation insurance companies in order to agree on fair workers comp settlements.
A workers comp attorney is also referred to as employment lawyer, injury lawyer, or accident lawyer. Some of the bigest and best law firms in Houston may have a personal injury lawyer or two, that specialize not only in workers compensation insurance claims, but personal injuries as well. Not to belabor the point, but A workers comp attorney can also specialize as a car accident lawyer that can represent victims of injuries sustained in car accidents.
Back to on job injuries. A workers comp attorney can help determine if the injured worker has a chance to benefit from workers’ compensation insurance while they seek medical treatment for their injuries and during their recovery. In very difficult cases a workers compensation board may be called upon to settle the claim.
worker compensation is a form of insurance that a majority of employers in Texas are required to provide for their workers. Employment lawyers are well trained in the “ins and outs” of workers comp insurance and can help employees get workers compensation settlements that are fair.
The Rights Of Injured Workers to Have Workmans Comp Insurance
In Texas, a worker that was injured at work has certain rights when it comes to the Texas workers’ compensation system. These rights include:
- The right to have a workers comp attorney assist the injured worker at any time during the workers’ compensation claims process;
- The right to request assistance from the Office of Injured Employee Counsel if the injured worker does not have a workers comp attorney;
- If eligible and regardless of fault, the injured worker may have the right to financial and medical benefits through workers’ compensation (with limited exceptions), and surviving family members may have a right to burial and death benefits if the eligible injured worker were to pass away due to their work-related injuries or illness;
- The right to medical care to treat the workplace injury or illness for as long as treatment is required;
- The right to receive income benefits for the work-related injury or illness;
- The right to dispute resolution regard claims concerning income or death benefits;
- The right to choose a treating doctor within the Workers’ Compensation Health Care Network; and
- The right to have all workers’ compensation claim information kept confidential.
The Responsibilities Of Injured Workers
Under workers compensation laws in Texas, injured workers have certain responsibilities. Texas workers compensation law says if workers want to be eligible for workers’ compensation benefits they must fulfill the following responsibilities:
- The responsibility of reporting any work-related injuries or illness to an employer within 30 days of incurring the injury or illness;
- The responsibility of determining whether the worker is part of a Workers’ Compensation Health Care Network;
- The responsibility of determining how to receive medical treatment if the worker belongs to a political subdivision, which can working for a school district, a city, or a county;
- The responsibility of informing the treating doctor about the injury or illness and whether it is work-related;
- The responsibility of completing and submitting an Employee’s Claim for Compensation for a Work-Related Injury or Occupational Claim Form to the Texas Division of Workers’ Compensation;
- The responsibility of providing current contact information to the Texas Division of Workers’ Compensation;
- The responsibility of notifying the workers’ compensation insurance provider and the Texas Division of Workers’ Compensation if the injured worker’s employment status changes;
- If the injured worker passes away due to their work-related injury or illness, the surviving family members have the responsibility of completing and submitting a Beneficiary Claim for Death Benefits to the Texas Division of Workers’ Compensation within one year from the death of the worker; and
- The responsibility of not making a fraudulent or frivolous claim.
Types of workmans comp insurance Benefits
In Texas, workers’ compensation is available in four different types of benefits:
- Medical Benefits. Medical benefits allow injured workers to pay for the medical care that they need to treat only their work-related injury or illness. There may be restrictions in place on obtaining medical benefits, such as having to obtain medical treatment within the workers’ compensation insurance provider’s service area or having to choose a doctor from a prescribed list of network care providers (although if the injured worker requires emergency care for a life threatening aspect of their work-related injury or illness, the worker may seek treatment at any emergency care facility).
- Income Benefits. In Texas, injured workers are eligible for four different types of “income” benefits. Each type of income benefit has its own qualification criteria which must be satisfied in order for the benefit to be paid to the injured worker.
- Temporary Income Benefits (TIBs). Temporary income benefits are paid when a worker’s injury or illness causes the worker to miss seven or more days of work. After missing eight days of work, an injured worker can become eligible for temporary income benefits. The amount paid for TIBs is 70 percent of the difference between the worker’s average weekly wage and any wages the injured worker is still able to earn after their work related injury. These benefits could continued to be paid to an injured worker even if the worker returns to work, but in a modified position that accommodates their injury. If the worker receives a reduced wage in the modified position, TIBs can continue. As a general rule, TIBs cease after 104 weeks of payment, or once the injured worker has reached their maximum medical improvement, as deemed by the worker’s health care provider. To think of them another way, TIBs are wage replacement benefits.
- Impairment Income Benefits (IIBs). Injured workers could receive impairment income benefits in Texas when the worker suffers a permanent impairment as a result of their work-related injury. After an injured worker has reached their maximum medical improvement, or the best level of recovery that they will likely be able to make, a health care provider can assign the injured worker an impairment rating. The worker’s impairment rating determines whether they are eligible for IIBs. IIBs are paid based on a worker’s impairment rating. Three weeks of IIB benefits are paid per percentage of their impairment rating. IIBs are paid at 70 percent of the worker’s average weekly wage, or 70 percent of the state average weekly wage (the latter serves as a cap on IIBs).
- Supplemental Income Benefits (SIBs). When a worker has an impairment rating of 15 percent or more, has not returned to work due to their impairment (or has returned but can only make less than 80 percent of their pre-work injury average weekly wage), is searching for work, and did not take IIBs in a lump sum payment, the injured worker could be eligible for supplemental income benefits. SIBs pay out at 80 percent of the difference between 80 percent of the worker’s pre-injury average weekly wage and the worker’s post-injury weekly wages. SIBs must be applied for each quarter after IIBs have terminated, and are paid on a monthly basis. SIBs end after 401 weeks (roughly 7.5 years) from when the worker suffered the injury.
- Lifetime Income Benefits (LIBs). Some injuries could entitle an injured worker to lifetime income benefits. For instance:
- Losing both feet above the ankle, or both hands above the wrist, or any combination thereof;
- Complete paralysis of both legs, both arms, or one of each;
- A complete and permanent loss of vision in both eyes;
- A traumatic brain injury that produces insanity or makes the worker permanently mentally disabled; or
- Third degree burns that either cover 40 percent of the body and require grafting, or cover both hands or a hand and the face.
These are all injuries that could make an injured worker eligible for LIBs. LIBs are paid at 75 percent of an injured worker’s average weekly salary, where the average weekly salary is subject to a 3 percent raise, or increase, each year. LIBs are applied for through a written request made with the workers’ compensation insurance carrier.
- Death Benefits. When a worker dies as a result of a work-related injury, the decedent’s family (i.e., a surviving spouse, minor children, dependent grandchildren, and other dependents) may be eligible for death benefits through workers’ compensation. Death benefits are paid at 75 percent of the deceased worker’s average weekly wage, subject to maximum and minimum death benefit caps.
- A surviving spouse is eligible for death benefit payments for the remainder of their lifetime, unless they remarry. Upon remarriage, the surviving spouse can obtain a lump sum payment of one year’s worth of death benefits.
- A surviving child can receive death benefits until reaching the age of 18, or 25 if the child remains enrolled full-time in an accredited educational institution. Death benefits paid to children are redistributed to the younger children when an older child becomes ineligible due to their age.
- A surviving grandchild that is 20 percent dependent upon the decedent may be eligible for death benefits until the age of 18, unless the grandchild’s own parents are eligible themselves for death benefits. Grandchildren who are not under the age of 18 at the time of the decedent’s death can only obtain 364 weeks worth of death benefits.
- Non-dependent parents may collect death benefits if there is no surviving spouse, children or grandchildren, but benefits are limited to 104 weeks worth of death benefits.
- Burial Benefits. Whoever pays for the burial of a deceased worker can obtain burial expenses for the deceased worker. Burial benefits are paid out as reimbursements.
Can I Choose My Own Doctor?
In Texas, in order to obtain workmans comp benefits, an injured employee must select a designated doctor in order to obtain a medical examination for the purpose of determining whether the injured worker is eligible for workers compensation. The doctor must be one that is designated by the Texas Department of Insurance Division of Workers’ Compensation. Injured workers can choose from a listing of designated treating doctors.
In most cases, employers have information for injured workers on how to find a designated doctor within the employer’s workers’ compensation insurance provider’s health care network. Injured workers can request this information from their employers. Once the injured worker is in contact with a participating treating doctor, they will be able to direct the injured worker to other in-network specialists or care providers as needed.
In some situations an employer may not have a care provider requirement, which means that the injured worker will have to locate a designated doctor. In these cases, the best place to start is with the worker’s normal health care provider. If the worker’s normal health care provider works with workers’ compensation patients, then the normal health care provider should suffice. If not, the worker can ask their normal health care provider for a recommendation. When all else fails, a workers’ compensation designated doctor can be located in the telephone directory or on the internet.
In emergency care situations, an injured worker may seek emergency care from any hospital or doctor. Once any initial trauma or life-threatening risks are alleviated, the injured worker must locate and visit a designated workers’ compensation treating doctor for all further treatment of the work-related injury or illness. Only after emergency medical and urgent follow up, should the services of a work related injury attorney be sought.
There are two reasons to wait to seek the advice from a Houston personal injury lawyer, or workers comp lawyer. The first is obvious, you don’t want to lose precious time getting medical treatment. The second is not so obvious. If you wait to see what the doctors will say and wait to see what kind of bills you start to rack up before contacting workers comp attorney you will have more information to offer the list of the workers compensation lawyers that you interview. This information will help a lawyer to make a stronger case in your favor.
Regarding a Work Compensation Case What Is the Responsibility Of A Designated Doctor?
In addition to a employment attorney defending the work compensation, a designated doctor will be tasked with performing an examination and providing a recommendation about the injured worker’s condition. Furthermore, the designated doctor may be relied upon to resolve a dispute concerning a work-related injury. Additionally, the designated doctor called on to:
- Consolidate and review any medical records and information related to the work-related injury or illness;
- Conduct tests, exams, scans, etc., as needed to fully assess the injury;
- Assess whether the injured worker has obtained maximum medical improvement, and when medical maximum improvement was reached by the injured worker;
- After maximum medical improvement is reached, assign an impairment rating; and
- Produce and submit a medical evaluation report for the injured worker to the Texas Division of Workers’ Compensation and insurance provider within seven days of the medical examination, which includes a narrative report and other documentation concerning the injured worker’s impairment rating.
Going Back To Work After An Injury Workers Compensation Forms
The ideal scenario for an injured worker is to obtain workers’ compensation benefits for a work-related injury or illness until the worker is ready and well-enough to return to work. This keeps the worker productive and engaged in their work, and reduces the costs associated with the worker’s injury and time off from work. Sometimes, as you may expect, the employer may pressure the worker to return to work earlier than advised by a doctor, of course this is a no no, but believe it or not, lawyers in Houston often have to intervene on the behalf of employees to let the employer know he needs to back off with the pressure and allow the employee ample time to re-coop.
After recovering from a work-related injury or illness, a worker can return to work. The injured worker does not necessarily have to be fully recovered in order to return to work. Injured workers who are nearly recovered and eager to return to work should discuss the possibility of returning to work early with both their designated doctor and their employer. The designated doctor may discuss options with the worker, and authorize them to make a return to work. Before returning to work however, the employee should be familiar with any related instructions to returning to work early in the workers comp forms. In other words the employee should read the “fine print”. Also check with the workers comp attorney that handled the case and be sure that the employee is not in jeopardy of losing his worker compensation insurance due to agreeing to accept a temporary position offered by the employer for the injured worker. There should be at least some degree of worker comp insurance available until the worker has made a full recovery.
Some employers have Return to Work Programs, which is a program designed to get injured workers back into the workplace by providing returning workers with temporary assignments or modifying their previous job tasks to accommodate the worker’s state of recovery. The thought process behind the program is that some work is better than no work, so getting the worker back into the workforce will promote productivity, stability and normalcy.
Any workers’ compensation benefits that the worker was receiving may be suspended or reduced based on whether the worker is working in a limited capacity upon returning to work. Whether benefits are lost depends on whether the worker remains eligible to receive them, and what the worker’s actual wage is compared to their pre-injury wage.
If you are in “lawyer search mode” for a Houston workers comp attorney to get a fair workers comp settlement, then contact a Houston workers comp attorney today for a FREE consultation.